Providence Dermatology LLC

NPI #1568029957 in Providence, Utah

Provider Information

NPI Number: 1568029957
Entity Type: Organization
Organization Name: Providence Dermatology LLC
Primary Specialty: Dermatology
Enumeration Date: May 22, 2019
Last Updated: Jun 16, 2025

Practice Location

Address: 169 N GATEWAY DR STE 100
City: Providence
State: Utah
ZIP Code: 84332-9860
Phone: (541) 999-4475

Authorized Official

Name: TRAVIS S JAMES, DO
Title: OWNER/PHYSICIAN
Phone: (435) 554-1182

Specialties & Taxonomy Codes

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

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