# ACADEMY DERMATOLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194162313
- **Authorized official:** DR. RONALD A JOHNSON M.D. (PRESIDENT)
- **Authorized official phone:** (719) 590-1800

## Contact information

- **Practice address:** 3615 HILL CIR, COLORADO SPRINGS, CO 80904-1076
- **Practice address phone:** (719) 590-1800
- **Practice address fax:** (719) 590-1858
- **Mailing address:** 3246 CENTENNIAL BLVD \# 112, COLORADO SPRINGS, CO 80907-4077
- **Mailing address phone:** (719) 590-1800
- **Mailing address fax:** (719) 590-1858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 24691 | CO | Yes |

## Other

- **Enumeration date:** 05/29/2013
- **Last updated:** 07/12/2023