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General NPI Number Information
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NPI Number | 1275473795
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Entity Type | Organization
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Legal Business Name | TC DERMATOLOGY, PLC
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Dates
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Enumeration Date | 04/01/2026
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 16 TAFT ST N STE 1
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City | HUMBOLDT
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State | IA
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Zip | 50548-1704
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Country | US
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Telephone | 515-570-1069
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Fax | 515-600-1108
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Provider Business Mailing Address
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Address Line | 16 TAFT ST N STE 1
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City | HUMBOLDT
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State | IA
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Zip | 50548-1704
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Country | US
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Telephone | 515-570-1069
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Fax | 515-600-1108
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Authorized Official
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Title or Position | PROVIDER
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Name | TAYLOR GIDEL
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Credential | PA-C, DMS
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Telephone | 515-890-9463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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