Organization
HIGH VALLEY DERMATOLOGY & DERMATOLOGIC SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON MINER D.O. (OFFICE MANAGER)
(208) 525-4888
Entity
Organization
Contact information
Practice address
2085 PROVIDENCE WAY, IDAHO FALLS, ID 83404-4945
(208) 525-4888
Mailing address
2085 PROVIDENCE WAY, IDAHO FALLS, ID 83404-4945
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
O-0568
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528279189
NPI
—
Enumeration date
10/25/2013
Last updated
04/13/2026
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