JORDAN VALLEY DERMATOLOGY is a specialist in Casper, WY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. JORDAN VALLEY DERMATOLOGY NPI is 1073954913. The provider is registered as an organization entity type and is a single specialty group. The provider Former Legal Business Name Is Jordan Valley Dermatology.
The provider's business location address is:
428 S DURBIN ST STE 103 CASPER, WY ZIP 82601-829 Phone: (307) 234-0003 Fax: (307) 265-6575
The provider's authorized official is Virginia Louise Tubbs . The authorized official title is Owner and has the following contact phone number (307) 265-2936.
The CLIA number assigned to this NPI record is 53D2092856 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 7/8/2013 and was last updated on 6/21/2019.
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:
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: 11/21/2025
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