Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Advanced Dermatology of Wyoming, Inc

Organization Dermatology Physician · NPI 1427408319

Advanced Dermatology of Wyoming, Inc provides Dermatology Physician services in Jackson, Wyoming. Registered with an NPI since 2016.

In the registry since
2016
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

62 S Redmond St
Jackson, WY 83001-8664 Not confirmed with CMS for 10 years — call before visiting
Phone: (307) 734-5864
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1427408319
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Linda Crandall — Credentialing Coordinator · (970) 484-3050
NPI enumeratedJune 21, 2016
Last updated in NPPESOctober 6, 2016
Mailing addressPo Box 7406, Jackson, WY 83002-7406

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