NPI 1194044750

Teton Dermatology LLC

Organisation Dermatology Physician Jackson, WY

Practice location

Address: 984 West Broadway Suite 4, Jackson, WY 83001-0000
Phone: (307) 734-1800
Fax: (307) 734-5012
Mailing address: 7300 Ranch Rd. 2222, Bldg 1, STE 200, Austin, TX 78730

Authorised official

Name: Gheorghe Pusta
Title: Executive Director
Phone: (512) 628-0465

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in Wyoming →

Registry record

NPI: 1194044750
Entity type: Organization
NPI issued: 21 May 2010
Record last updated: 18 Sep 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.