Healthcare Provider Details

I. General information

NPI: 1114093846
Provider Name (Legal Business Name): DERMATOLOGY ASSOCIATES PLLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 COMMONS LOOP STE 300
KALISPELL MT
59901
US

IV. Provider business mailing address

175 COMMONS LOOP STE 300
KALISPELL MT
59901
US

V. Phone/Fax

Practice location:
  • Phone: 406-756-7555
  • Fax: 406-756-7517
Mailing address:
  • Phone: 406-756-7555
  • Fax: 406-756-7517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID K MURDOCK
Title or Position: MANAGING OFFICER
Credential: MD
Phone: 406-756-7555