Ada Dermatology, P.A. in Boise - Procedural Dermatology
Ada Dermatology, P.A. - NPI 1952483299
Ada Dermatology, P.A. is a Procedural Dermatology in Boise, Idaho. Ada Dermatology, P.A. practices all healthcare services and medical treatments related to Procedural Dermatology. The NPI Number for Ada Dermatology, P.A. is 1952483299. The last update date is 2012-01-30.
Ada Dermatology, P.A.'s current location address is 6454 W Emerald Street, Boise, Idaho. You can contact this provider via phone number 2083770820. The mailing address for Ada Dermatology, P.A. is 6454 W Emerald Street, Boise, Idaho. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Ada Dermatology, P.A. |
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Address | 6454 W Emerald Street, Boise, Idaho |
Phone Number | 2083770820 |
Fax Number | |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | PRESIDENT |
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Authorized Official Name | Blickenstaff Dale Richard |
Credentials | M.D. |
Telephone Number | 2083770820 |
NPI Number Detail
NPI Number | 1952483299 |
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Provider Enumeration Date | 2006-10-19 |
Last Updated Date | 2012-01-30 |
Provider Mailing Address Detail
Address | 6454 W Emerald Street |
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City | Boise |
State | Idaho (ID) |
Post Code | 837048734 |
Phone Number | 2083770820 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Procedural Dermatology |
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Taxonomy | 207Ns0135X |
Licence No | M-5274 |
Definition: Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surge |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
2639100 | ID | -- |
Post Comment/ Review Below
What is the Ada Dermatology, P.A.'s unique identification number?
The Ada Dermatology, P.A. has been assigned the NPI (National Provider Identifier) Number 1952483299 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you kindly provide the complete physical address where Ada Dermatology, P.A.'s facilities are geographically located?
The facilities of Ada Dermatology, P.A. are physically situated at the following location: 6454 W Emerald Street, Boise, ID, 837048734.
What is Ada Dermatology, P.A.'s specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Ada Dermatology, P.A.'s specialized field of practice is Procedural Dermatology, and the corresponding taxonomy code that categorizes this area of specialization is 207Ns0135X.
On what date did the Ada Dermatology, P.A. receive the assignment of its 1952483299 from the Centers for Medicare & Medicaid Services?
The Ada Dermatology, P.A. was issued its 1952483299 by the Centers for Medicare & Medicaid Services on 2006-10-19.
As of what date were the details related to Ada Dermatology, P.A. most recently updated or revised?
The information pertaining to Ada Dermatology, P.A., including its address, specialty, and other relevant details, was last updated or revised on 2012-01-30.
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