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IDAHO SKIN SURGERY CENTER PC NPI 1295908127


NPI Information

NPI: 1295908127
Provider Name: IDAHO SKIN SURGERY CENTER, PC
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 13D1084633

Address:
1906 S VISTA AVE
BOISE, ID
ZIP 83705
Phone: (208) 433-1114
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IDAHO SKIN SURGERY CENTER, PC is a dermatology in Boise, ID. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. IDAHO SKIN SURGERY CENTER, PC NPI is 1295908127. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1906 S VISTA AVE
BOISE, ID
ZIP 83705-453
Phone: (208) 433-1114
Fax: (208) 433-1115

The provider's authorized official is Jared Scott .
The authorized official title is President and has the following contact phone number (208) 433-1114.

The CLIA number assigned to this NPI record is 13D1084633 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/11/2008 and was last updated on 12/12/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic SurgeryM-10116IDAHONo
2207NS0135XDermatologyProcedural DermatologyM-10116IDAHONo
3207N00000XDermatologyM-10116IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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