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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

EAGLE DERMATOLOGY, PLLC

Active Organization

EAGLE DERMATOLOGY, PLLC is a Dermatology organization located in EAGLE, Idaho. NPI 1417456385 is currently active in the NPPES registry. Verify at CMS.

Dermatology · EAGLE, ID

Registration Details

NPI Number
1417456385
Provider Type
Organization
NPI Issued
Feb 6, 2018 (8.5277234815689 yrs)
Last Updated
Feb 6, 2018
Licenses
O-1094 (ID)
O-1094 (ID)
O-1094 (ID)
O-1094 (ID)
O-1094 (ID)

Practice Information

Address
323 E RIVERSIDE DR STE 234
EAGLE, ID, 836166865
Browse ID providers · Browse ZIP 83616
Phone
2083917210
Fax
2083912130
Primary Specialty
Dermatology
207N00000X
Additional Specialty
Dermatopathology
Additional Specialty
207NP0225X
Additional Specialty
Procedural Dermatology

Other Dermatology Organizations in EAGLE, ID

Name NPI
KELLER SKIN & CANCER CARE PC 1649543323
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.