OrganizationActive
Advanced Dermatology of Wyoming, Inc
NPI 1427408319 · Dermatology Physician · Jackson, WY
Provider details
- NPI number
- 1427408319
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Linda Crandall, Credentialing Coordinator(970) 484-3050
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
62 South Redmond Street
Jackson, WY 83001-8664
Phone: (307) 734-5864
Street-level locationGet directions
Mailing address
Po Box 7406
Jackson, WY 83002-7406
Registry dates
- Enumerated
- 2016-06-21
- Last updated
- 2016-10-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.