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

Prescott Medical and Dermatology Group

Organization Dermatology Physician · NPI 1841929908

Prescott Medical and Dermatology Group is a Dermatology Physician in Prescott, Arizona. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
3

Practice location Address checks out

810 Ainsworth Dr
Prescott, AZ 86301-1612
Phone: (928) 515-1155
Fax: (928) 460-5158
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
Family Medicine Physician Taxonomy 207Q00000X
Plastic Surgery Physician Taxonomy 208200000X

Record details

NPI number1841929908
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Burt Faibisoff — Physician/Owner · (602) 476-4074
NPI enumeratedJune 6, 2022
Last updated in NPPESNovember 10, 2025
Certification dateNovember 10, 2025
Mailing address810 Ainsworth Dr, Prescott, AZ 86301-1612

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