OrganizationActive
High Valley Dermatology & Dermatologic Surgery PLLC
NPI 1063840288 · MOHS-Micrographic Surgery Physician · Idaho Falls, ID
Provider details
- NPI number
- 1063840288
- Entity type
- Organization
- Primary specialty
- MOHS-Micrographic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Brandon Miner, Office Manager(208) 525-4888
- License
- O-0568 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2085 Providence Way
Idaho Falls, ID 83404-4945
Phone: (208) 525-4888
Approximate (ZIP-level) locationGet directions
Mailing address
2085 Providence Way
Idaho Falls, ID 83404-4945
Registry dates
- Enumerated
- 2013-10-25
- Last updated
- 2026-04-13
- Certified
- 2026-04-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.