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ALPINE DERMATOLOGY CLINIC P.C. NPI 1588802391


NPI Information

NPI: 1588802391
Provider Name: ALPINE DERMATOLOGY CLINIC P.C.
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

CLIA Number: 13D2212803

Address:
1049 SUMMERS DR
REXBURG, ID
ZIP 83440
Phone: (208) 359-4841
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ALPINE DERMATOLOGY CLINIC P.C. is a medical specialty clinic center in Rexburg, ID. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). ALPINE DERMATOLOGY CLINIC P.C. NPI is 1588802391. The provider is registered as an organization entity type.

The provider's business location address is:

1049 SUMMERS DR
REXBURG, ID
ZIP 83440-335
Phone: (208) 359-4841

The provider's authorized official is Daniel R Marshall .
The authorized official title is Owner, Ceo and has the following contact phone number (208) 359-4841.

The CLIA number assigned to this NPI record is 13D2212803 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/2/2009 and was last updated on 4/5/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical SpecialtyO-0508IDAHOYes

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

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