Healthcare Provider Details

I. General information

NPI: 1316663297
Provider Name (Legal Business Name): DESERET DERMATOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1593 N REDWOOD RD STE 2
SARATOGA SPRINGS UT
84045-3919
US

IV. Provider business mailing address

1593 N REDWOOD RD STE 2
SARATOGA SPRINGS UT
84045-3919
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone: 385-333-3376
  • Fax: 801-872-5264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS K BARLOW
Title or Position: OWNER
Credential:
Phone: 385-333-3376