Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

High Valley Dermatology & Dermatologic Surgery PLLC

Organization MOHS-Micrographic Surgery Physician · NPI 1063840288

High Valley Dermatology & Dermatologic Surgery PLLC provides MOHS-Micrographic Surgery Physician services in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2013.

Licensed in
ID
In the registry since
2013
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2085 Providence Way
Idaho Falls, ID 83404-4945
Phone: (208) 525-4888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence O-0568 (ID)

Record details

NPI number1063840288
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brandon Miner — Office Manager · (208) 525-4888
NPI enumeratedOctober 25, 2013
Last updated in NPPESApril 13, 2026
Certification dateApril 13, 2026
Mailing address2085 Providence Way, Idaho Falls, ID 83404-4945

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