Provider Demographics
NPI:1295984144
Name:DERMA TAUT INTERNATIONAL PC
Entity type:Organization
Organization Name:DERMA TAUT INTERNATIONAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-748-1220
Mailing Address - Street 1:PO BOX 3387
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CO
Mailing Address - Zip Code:81620-3387
Mailing Address - Country:US
Mailing Address - Phone:970-748-1220
Mailing Address - Fax:970-748-1255
Practice Address - Street 1:37347 US HIGHWAY 6 & 24
Practice Address - Street 2:SUITE 214
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620-3387
Practice Address - Country:US
Practice Address - Phone:970-748-1220
Practice Address - Fax:970-748-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01251891Medicaid
CO1407844335OtherDOCTOR NPI
CO01251891Medicaid