NPI 1659827665

Mountain Pine Dermatology, PLLC

Organisation Dermatology Physician Meridian, ID

Practice location

Address: 4664 N Penngrove Way STE 100, Meridian, ID 83646-7442
Phone: (208) 898-7467

Authorised official

Name: Richard Scott Thomas
Title: Owner
Phone: (208) 250-7433

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence O-0934 (ID)

Other Dermatology providers in Idaho →

Registry record

NPI: 1659827665
Entity type: Organization
NPI issued: 30 Aug 2016
Record last updated: 5 Jul 2020

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.