Providence Dermatology

LBN: Cbm Derm Llc
Providence Dermatology is an health care organization with primary practice located at 169 N Gateway Dr Ste 100 , Providence UT 84332-9860. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty. Cbm Derm Llc can be contacted via phone (541) 999-4475, or through James, Travis S via phone (435) 554-1182.

Contact Information

Primary practice address
169 N Gateway Dr Ste 100 Providence UT 84332-9860
Phone: (541) 999-4475
Fax:
Website:
Map and Directions
Authorized official contact:
Name: James, Travis S Doctor of Osteopathy (DO)
Phone: (435) 554-1182

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X

Profile Details

NPI number 1568029957
LBN Legal business name Cbm Derm Llc
DBA Doing business as Providence Dermatology
Authorized official James, Travis S Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date May 22nd, 2019
Last updated May 15th, 2024 - about 6 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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