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HIGH VALLEY DERMATOLOGY AND SURGERY NPI 1063840288


NPI Information

NPI: 1063840288
Provider Name: HIGH VALLEY DERMATOLOGY AND SURGERY
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

Address:
2085 PROVIDENCE WAY
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 525-4888
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HIGH VALLEY DERMATOLOGY AND SURGERY 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 AND SURGERY NPI is 1063840288. 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

The provider's authorized official is Brandon Miner .
The authorized official title is Office Manager and has the following contact phone number (208) 525-4888.

The enumeration date for this NPI number is 10/25/2013 and was last updated on 10/25/2013.


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 SurgeryO-0568IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11528279189OTHERNPI

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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