Organization
DERMATOLOGY CENTER OF THE ROCKIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTIN M BAIRD M.D. (PRESIDENT)
(303) 532-2810
Entity
Organization
Contact information
Practice address
1551 PROFESSIONAL LN, 135, LONGMONT, CO 80501-6972
(303) 532-2810
(303) 532-2816
Mailing address
1551 PROFESSIONAL LN, 135, LONGMONT, CO 80501-6972
(303) 532-2810
(303) 532-2816
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
CO
207ND0101X
MOHS-Micrographic Surgery Physician
—
CO
207NS0135X
Procedural Dermatology Physician
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58659099
—
CO
01
—
70016791
RAILROAD
CO
Enumeration date
08/22/2011
Last updated
08/22/2011
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