Organization
INTEGRATIVE DERMATOLOGY PA CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FEROZA THOMPSON PA-C (PHYSICIAN ASSOCIATE)
(941) 840-1387
Entity
Organization
Contact information
Practice address
1110 ECHO PASS ST., HENDERSON, NV 89052
(941) 840-1387
Mailing address
7533 S CENTER VIEW CT STE R, WEST JORDAN, UT 84084-5526
(941) 840-1387
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
03/05/2025
Last updated
03/07/2025
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