Eagle Dermatology, Pllc

LBN: Eagle Dermatology, Pllc
Eagle Dermatology, Pllc is an health care organization with primary practice located at 323 E Riverside Dr Ste 234 , Eagle ID 83616-6865. The organization recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Clinical & Laboratory Dermatological Immunology, Allopathic & Osteopathic Physicians / Pediatric Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty. Eagle Dermatology, Pllc can be contacted via phone (208) 391-7210, or through Guerrero, Jennifer Annette via phone (208) 391-7210.

Contact Information

Primary practice address
323 E Riverside Dr Ste 234 Eagle ID 83616-6865
Phone: (208) 391-7210
Fax: (208) 391-2130
Website:
Map and Directions
Authorized official contact:
Name: Guerrero, Jennifer Annette
Phone: (208) 391-7210

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X O-1094 Idaho
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X O-1094 Idaho
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X O-1094 Idaho
Allopathic & Osteopathic Physicians / Clinical & Laboratory Dermatological Immunology 207NI0002X O-1094 Idaho
Allopathic & Osteopathic Physicians / Pediatric Dermatology 207NP0225X O-1094 Idaho
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X O-1094 Idaho

Profile Details

NPI number 1417456385
LBN Legal business name Eagle Dermatology, Pllc
DBA Doing business as
Authorized official Guerrero, Jennifer Annette
Entity Organization
Organization subpart 1 No
Enumeration date Feb 6th, 2018
Last updated Feb 6th, 2018 - about 6 years 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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