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HIGH VALLEY DERMATOLOGY & DERMATOLOGIC SURGERY LLC NPI 1891025334


NPI Information

NPI: 1891025334
Provider Name: HIGH VALLEY DERMATOLOGY & DERMATOLOGIC SURGERY LLC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 13D2295000

Address:
2085 PROVIDENCE WAY
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 525-4888
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HIGH VALLEY DERMATOLOGY & DERMATOLOGIC SURGERY LLC is a mohs-micrographic surgery dermatology in Idaho Falls, ID. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. HIGH VALLEY DERMATOLOGY & DERMATOLOGIC SURGERY LLC NPI is 1891025334. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2085 PROVIDENCE WAY
IDAHO FALLS, ID
ZIP 83404-945
Phone: (208) 525-4888
Fax: (208) 525-4885

The provider's authorized official is Lindsay D Sewell .
The authorized official title is Manager and has the following contact phone number (208) 525-4888.

The CLIA number assigned to this NPI record is 13D2295000 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/6/2010 and was last updated on 1/6/2010.


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 SurgeryM10198IDAHOYes

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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