| NPI | 1568029957 |
|---|---|
| Doing Business As | PROVIDENCE DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | TRAVIS S JAMES Owner/Physician 435-554-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2024-05-15 |