SOUTHWEST DERMATOLOGY NPI 1518331420

NPI Information

  • NPI: 1518331420
  • Provider Name: SOUTHWEST DERMATOLOGY
  • Classification: Dermatology - 207NS0135X
  • Specialization: Procedural Dermatology
  • Entity Type: Organization
  • CLIA Number: 24D0402450
  • Address: 6425 NICOLLET AVENUE SOUTH
    SUITE 202
    RICHFIELD, MN
    ZIP 55423
  • Phone: (612) 869-2086

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NPI Details

SOUTHWEST DERMATOLOGY is a procedural dermatology dermatology in Richfield, MN. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). SOUTHWEST DERMATOLOGY NPI is 1518331420. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6425 NICOLLET AVENUE SOUTH
SUITE 202
RICHFIELD, MN
ZIP 55423-668
Phone: (612) 869-2086
Fax: (612) 869-4903

The provider's authorized official is Brian D Zelickson .
The authorized official title is Ceo and has the following contact phone number (952) 929-8888.

The CLIA number assigned to this NPI record is 24D0402450 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/17/2015 and was last updated on 1/25/2023.

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
1207NS0135XDermatologyProcedural DermatologyYes

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: 11/21/2025

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