Organization
DERMATOLOGY CENTER OF CANYON COUNTY
Active
Organization
DERMATOLOGY CENTER OF CANYON COUNTY
Active
Other names
Dermatology & Laser Center of Canyon County
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAVIN R POWELL M.D. (PRESIDENT)
(208) 467-3006
Entity
Organization
Contact information
Practice address
318 2ND ST S, NAMPA, ID 83651-3765
(208) 467-3006
(208) 467-1155
Mailing address
318 2ND ST S, NAMPA, ID 83651-3765
(208) 467-3006
(208) 467-1155
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M7519
ID
Other
Enumeration date
03/07/2007
Last updated
10/15/2007
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