Idaho Skin Institute LLC

NPI #1184375867 in Chubbuck, Idaho

Provider Information

NPI Number
1184375867
Entity Type
Organization
Organization Name
Idaho Skin Institute LLC
Primary Specialty
Dermatology
Enumeration Date
Jan 13, 2022
Last Updated
Feb 4, 2025

Practice Location

Address
147 W CHUBBUCK RD
State
Idaho
ZIP Code
83202-2314
Phone
(208) 238-7546

Authorized Official

Name
EARL STODDARD, MD
Title
OWNER
Phone
(208) 238-7546

Specialties & Taxonomy Codes

Specialty
Dermatology

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