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Issc Fruitland — NPI 1568112688, Fruitland, ID | NPI Central

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NPI 1568112688

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Issc Fruitland

NPI 1568112688 · Dermatology Physician · Fruitland, ID

Provider details

NPI number: 1568112688
Entity type: Organization
Primary specialty: Dermatology PhysicianAllopathic & Osteopathic Physicians
Parent organization: Idaho Skin Surgery Center, PC
Organization subpart: Yes
Authorized official: Celia Ramos, Practice Manager(208) 452-7450

Specialties & taxonomies

Dermatology PhysicianPrimary207N00000X
Allopathic & Osteopathic Physicians

Practice location

975 Nw 16th St.

Fruitland, ID 83619

Phone: (208) 452-7450

Fax: (208) 452-7550

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

975 Nw 16th St.

Fruitland, ID 83619

Registry dates

Enumerated: 2022-03-24
Last updated: 2025-07-16
Certified: 2025-07-03

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.