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Organization

CLOVIS DERMATOLOGY, INC

Active
Other names
Clovis Dermatology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAYMOND KIDWELL M.D. (CEO)
(559) 298-7220
Entity
Organization

Contact information

Practice address
275 W HERNDON AVE, CLOVIS, CA 93612-0204
(559) 321-4255
Mailing address
275 W HERNDON AVE, CLOVIS, CA 93612-0204
(559) 321-4255

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Enumeration date
02/14/2016
Last updated
03/23/2021
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