Pilot Butte Dermatology, L.c.

NPI #1871733238 in Evanston, Wyoming

Provider Information

NPI Number: 1871733238
Entity Type: Organization
Organization Name: Pilot Butte Dermatology, L.c.
Primary Specialty: Specialist
Enumeration Date: Feb 25, 2009
Last Updated: Mar 25, 2009

Practice Location

Address: 196 ARROWHEAD DR
Address 2: SUITE 5
City: Evanston
State: Wyoming
ZIP Code: 82930-8752
Phone: (877) 689-0005

Authorized Official

Name: DR. DOUGLASS W. FORSHA, M.D.
Title: PRESIDENT
Phone: (801) 569-1456

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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