Snake River Dermatology, PA
Snake River Dermatology, PA provides Dermatology Physician services in Fruitland, Idaho. Licensed in Idaho. Registered with an NPI since 2007.
- Licensed in
- ID
- In the registry since
- 2007
- Specialties on file
- 2
What do these letters mean?
- PA — Professional association
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1611 N Whitley Dr #7Fruitland, ID 83619 Not confirmed with CMS for 13 years — call before visiting
Phone: (208) 452-5999
Fax: (208) 452-4499
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dermatology Physician (primary) | Taxonomy 207N00000X · Licence M-11462 (ID) |
|---|---|
| Dermatology Physician | Taxonomy 207N00000X · Licence M3809 (ID) |
Record details
| NPI number | 1528263670 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Brock Andersen — Principal Officer · (208) 452-5999 |
| Other names | Gerald G. Overly, Md, Pa |
| NPI enumerated | June 19, 2007 |
| Last updated in NPPES | February 4, 2013 |
| Mailing address | 1611 N Whitley Dr, Suite #7, Fruitland, ID 83619 |
Other providers in Fruitland
-
Dr. Brock Arben Andersen, MD
2101 N Whitley Dr, Fruitland, ID 83619-2132 · (208) 452-5999
-
CT Derm PC
811 NW 12th St, Fruitland, ID 83619-2268 · (208) 452-7450
-
Issc Fruitland
975 NW 16th St, Fruitland, ID 83619 · (208) 452-7450
-
Carl R Thornfeldt, MD
811 NW 12th St, Fruitland, ID 83619-2268 · (208) 452-7450