NPI 1508345091

Integrated Dermatology of Idaho LLC

Organisation Dermatology Physician Boise, ID

Practice location

Address: 388 E Parkcenter Blvd, Boise, ID 83706-3942
Phone: (208) 424-9101
Fax: (208) 424-5072
Mailing address: 4700 Exchange CT STE 110, Boca Raton, FL 33431-4450

Authorised official

Name: Jeffrey Queen
Title: Owner
Phone: (561) 314-2000

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in Idaho →

Registry record

NPI: 1508345091
Entity type: Organization
NPI issued: 7 Aug 2018
Record last updated: 7 Aug 2018

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.