CENTER FOR DERMATOLOGY PLLC NPI 1174062673

NPI Information

NPI: 1174062673
Provider Name: CENTER FOR DERMATOLOGY, PLLC
Classification: Physician Assistant - 363AM0700X
Entity Type: Organization

Specialization: Medical

CLIA Number: 03D2054440

Address:
14275 N 87TH ST
SUITE 109 & 110
SCOTTSDALE, AZ
ZIP 85260
Phone: (480) 905-8485
Get Directions

CENTER FOR DERMATOLOGY, PLLC is a medical physician assistant in Scottsdale, AZ. CENTER FOR DERMATOLOGY, PLLC NPI is 1174062673. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

14275 N 87TH ST
SUITE 109 & 110
SCOTTSDALE, AZ
ZIP 85260-696
Phone: (480) 905-8485
Fax: (480) 905-7274

The provider's authorized official is Gary Mccracken .
The authorized official title is Owner/medical Provider and has the following contact phone number (480) 905-8485.

The CLIA number assigned to this NPI record is 03D2054440 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/16/2017 and was last updated on 11/7/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	6627	ARIZONA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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