Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

High Valley Dermatology & Dermatologic Surgery PLLC

Organization MOHS-Micrographic Surgery Physician · NPI 1063840288

High Valley Dermatology & Dermatologic Surgery PLLC is an MOHS-Micrographic Surgery Physician in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2013.

Licensed in
ID
In the registry since
2013
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2085 Providence Way
Idaho Falls, ID 83404-4945
Phone: (208) 525-4888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence O-0568 (ID)

Record details

NPI number1063840288
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brandon Miner — Office Manager · (208) 525-4888
NPI enumeratedOctober 25, 2013
Last updated in NPPESApril 13, 2026
Certification dateApril 13, 2026
Mailing address2085 Providence Way, Idaho Falls, ID 83404-4945

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