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Organization
PREMIER DERMATOLOGY & SKIN RENEWAL CENTER
Active
Organization
PREMIER DERMATOLOGY & SKIN RENEWAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF CLIFTON (COO)
(479) 273-3376
Entity
Organization
Contact information
Practice address
909 SE 28TH ST, STE 5, BENTONVILLE, AR 72712-3880
(479) 273-3376
(479) 273-3468
Mailing address
909 SE 28TH ST, STE 5, BENTONVILLE, AR 72712-3880
(479) 273-3376
(479) 273-3468
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
E3363
AR
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
Primary
—
AR
207NP0225X
Pediatric Dermatology Physician
E3363
AR
207NS0135X
Procedural Dermatology Physician
E3363
AR
Other
Enumeration date
07/31/2006
Last updated
09/11/2025
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