NPI 1295908127

Idaho Skin Surgery Center, PC

Organisation Dermatology Physician Boise, ID

Practice location

Address: 1906 S Vista Ave, Boise, ID 83705-3453
Phone: (208) 433-1114
Fax: (208) 433-1115

Authorised official

Name: Jared Scott
Title: President
Phone: (208) 433-1114

Registered specialties (3)

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence M-10116 (ID)

Other Dermatology providers in Idaho →

MOHS-Micrographic Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 207ND0101X Licence M-10116 (ID)

Procedural Dermatology Physician

Allopathic & Osteopathic Physicians Taxonomy 207NS0135X Licence M-10116 (ID)

Registry record

NPI: 1295908127
Entity type: Organization
NPI issued: 11 Apr 2008
Record last updated: 12 Dec 2014

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.