LP Derm LLC

NPI #1538875786 in Providence, Utah

Provider Information

NPI Number: 1538875786
Entity Type: Organization
Organization Name: LP Derm LLC
Subpart: Yes (part of a larger organization)
Parent Organization: LP DERM LLC
Primary Specialty: Dermatology
Enumeration Date: Jan 30, 2023
Last Updated: Jan 30, 2023

Practice Location

Address: 517 W 100 N STE 103
City: Providence
State: Utah
ZIP Code: 84332-9824
Phone: (435) 554-8442

Authorized Official

Name: CORY B MAUGHAN, DO
Title: OWNER
Phone: (435) 554-8442

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology - MOHS-Micrographic Surgery — MOHS-Micrographic Surgery	207ND0101X
Dermatology	207N00000X	Primary

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