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COLORADO SPRINGS DERMATOLOGY CLINIC P.C. NPI 1720685894


NPI Information

NPI: 1720685894
Provider Name: COLORADO SPRINGS DERMATOLOGY CLINIC, P.C.
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 06D2187741

Address:
1332 BAUER LN
CANON CITY, CO
ZIP 81212
Phone: (719) 275-7485
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COLORADO SPRINGS DERMATOLOGY CLINIC, P.C. is a mohs-micrographic surgery dermatology in Canon City, CO. 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. COLORADO SPRINGS DERMATOLOGY CLINIC, P.C. NPI is 1720685894. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1332 BAUER LN
CANON CITY, CO
ZIP 81212-669
Phone: (719) 275-7485
Fax: (719) 275-5331

The provider's authorized official is Sandy Wallace .
The authorized official title is Billing Department Manager and has the following contact phone number (719) 471-1763.

The CLIA number assigned to this NPI record is 06D2187741 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/2/2020 and was last updated on 5/3/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyNo
2207ND0101XDermatologyMOHS-Micrographic SurgeryYes

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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