Organization
MOUNTAIN DERMATOLOGY SPECIALISTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN L URQUHART MD (PHYSICIAN OWNER)
(970) 926-1800
Entity
Organization
Contact information
Practice address
105 EDWARDS VILLAGE BOULEVARD, SUITE G211, EDWARDS, CO 81632-3211
(970) 926-1800
(888) 505-2650
Mailing address
PO BOX 2606, EDWARDS, CO 81632-2606
(970) 926-1800
(888) 505-2650
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
38262
CO
207N00000X
Dermatology Physician
Primary
—
CO
207ND0900X
Dermatopathology Physician
38262
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60738740
—
CO
Enumeration date
12/12/2011
Last updated
01/23/2018
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