Provider Demographics
NPI:1881330421
Name:INFINITY DERMATOLOGY PLLC
Entity type:Organization
Organization Name:INFINITY DERMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATELIN
Authorized Official - Middle Name:JUDITH
Authorized Official - Last Name:HARTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:515-524-6060
Mailing Address - Street 1:903 WILLSON AVE
Mailing Address - Street 2:
Mailing Address - City:WEBSTER CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50595-2214
Mailing Address - Country:US
Mailing Address - Phone:515-524-6060
Mailing Address - Fax:515-524-6061
Practice Address - Street 1:903 WILLSON AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER CITY
Practice Address - State:IA
Practice Address - Zip Code:50595-2214
Practice Address - Country:US
Practice Address - Phone:515-297-3701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center