National Provider Identifier Database

ALPINE DERMATOLOGY CLINIC PC
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

ALPINE DERMATOLOGY CLINIC P.C.
1049 SUMMERS DR
REXBURG, ID83440-5335
Phone: 208-359-4841
Fax:
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for ALPINE DERMATOLOGY CLINIC P.C.

NPI Number 1588802391
Legal business name
LBN
ALPINE DERMATOLOGY CLINIC P.C.
Authorized official DANIEL MARSHALL - (OWNER, CEO)
Entity Organization
Organization subpart No
Enumeration date 02/02/2009
Last updated 04/05/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • ID License #: O-0508

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for ALPINE DERMATOLOGY CLINIC P.C.

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