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

Innovative Dermatology Alliance Az, PC

Organization Dermatology Physician · NPI 1215559471

Innovative Dermatology Alliance Az, PC is a Dermatology Physician in Wickenburg, Arizona. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

390 Bralliar Rd
Wickenburg, AZ 85390
Phone: (602) 971-0268
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1215559471
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Christopher Rex — Owner · (904) 994-4533
NPI enumeratedMay 11, 2020
Last updated in NPPESNovember 27, 2023
Certification dateMay 11, 2020
Mailing address3318 W Lucia Dr, Phoenix, AZ 85083-5884