NPI 1427408319

Advanced Dermatology of Wyoming, INC

Organisation Dermatology Physician Jackson, WY

Practice location

Address: 62 South Redmond Street, Jackson, WY 83001-8664
Phone: (307) 734-5864
Mailing address: PO Box 7406, Jackson, WY 83002-7406

Authorised official

Name: Linda Crandall
Title: Credentialing Coordinator
Phone: (970) 484-3050

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in Wyoming →

Registry record

NPI: 1427408319
Entity type: Organization
NPI issued: 21 Jun 2016
Record last updated: 6 Oct 2016

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.