Provider Demographics
NPI:1114093846
Name:DERMATOLOGY ASSOCIATES PLLP
Entity Type:Organization
Organization Name:DERMATOLOGY ASSOCIATES PLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:MURDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-756-7555
Mailing Address - Street 1:175 COMMONS LOOP
Mailing Address - Street 2:STE 300
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-756-7555
Mailing Address - Fax:406-756-7517
Practice Address - Street 1:175 COMMONS LOOP
Practice Address - Street 2:STE 300
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-756-7555
Practice Address - Fax:406-756-7517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty