Eagle Dermatology, PLLC
Eagle Dermatology, PLLC is a Dermatology Physician in Eagle, Idaho. Licensed in Idaho. Registered with an NPI since 2018.
- Licensed in
- ID
- In the registry since
- 2018
- Specialties on file
- 6
What do these letters mean?
- PLLC — Professional limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
323 E Riverside Dr Ste 234Eagle, ID 83616-6865
Phone: (208) 391-7210
Fax: (208) 391-2130
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dermatology Physician (primary) | Taxonomy 207N00000X · Licence O-1094 (ID) |
|---|---|
| MOHS-Micrographic Surgery Physician | Taxonomy 207ND0101X · Licence O-1094 (ID) |
| Dermatopathology Physician | Taxonomy 207ND0900X · Licence O-1094 (ID) |
| Clinical & Laboratory Dermatological Immunology Physician | Taxonomy 207NI0002X · Licence O-1094 (ID) |
| Pediatric Dermatology Physician | Taxonomy 207NP0225X · Licence O-1094 (ID) |
| Procedural Dermatology Physician | Taxonomy 207NS0135X · Licence O-1094 (ID) |
Record details
| NPI number | 1417456385 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jennifer Guerrero — Practice Manager · (208) 391-7210 |
| NPI enumerated | February 6, 2018 |
| Last updated in NPPES | February 6, 2018 |
| Mailing address | 372 S Eagle Rd # 126, Eagle, ID 83616-5908 |
Other providers in Eagle
-
Dr. Gregory Lynn Flint, MD
868 E Riverside Dr Ste 200, Eagle, ID 83616-6019 · (208) 367-2864
-
Keller Skin & Cancer Care PC
1605 E Riverside Dr, Eagle, ID 83616 · (208) 939-6227
-
Dr. Wade Robert Keller, DO
1605 E Riverside Dr, Eagle, ID 83616-6237 · (208) 939-6227
-
Heather Nicole Knutson, NP
1605 E Riverside Dr, Eagle, ID 83616-6237 · (208) 939-6227