Provider Demographics
NPI:1558313528
Name:SCHOLES AND SCHOLES DERMATOLOGY
Entity Type:Organization
Organization Name:SCHOLES AND SCHOLES DERMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHRIS SCHOLES PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:THAD
Authorized Official - Last Name:SCHOLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-734-5555
Mailing Address - Street 1:526 SHOUP AVE W
Mailing Address - Street 2:SUITE A
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6050
Mailing Address - Country:US
Mailing Address - Phone:208-734-5555
Mailing Address - Fax:208-734-4790
Practice Address - Street 1:526 SHOUP AVE W
Practice Address - Street 2:SUITE A
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6050
Practice Address - Country:US
Practice Address - Phone:208-734-5555
Practice Address - Fax:208-734-4790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID808049600Medicaid
ID808049600Medicaid