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Contact Information

PARK CITY DERMATOLOGY. CO
1790 SUN PEAK DR STE A103
PARK CITY, UT84098
 Phone: 435-658-1013
 Fax: 435-658-3513
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for PARK CITY DERMATOLOGY. CO

NPI Number 1316095722
LBN Legal business name PARK CITY DERMATOLOGY. CO
Authorized official STEVEN KERN - (PRESIDENT)
Entity Organization
Organization subpart 1 Yes
Enumeration date 01/08/2007
Last updated 03/07/2023 - About 3 years ago
Identifiers
UT License # 3673151205
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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