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Organization

MERIDIAN DERMATOLOGY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN JEFFREY HARRIS MD (OWNER, PHYSICIAN)
(434) 987-3922
Entity
Organization

Contact information

Practice address
3250 N LESLIE WAY STE 110, MERIDIAN, ID 83646-5362
(208) 609-9500
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Enumeration date
10/06/2021
Last updated
02/22/2023
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