=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295984144
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DERMA TAUT INTERNATIONAL PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2008
-----------------------------------------------------
Last Update Date | 05/31/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 37347 US HIGHWAY 6 & 24 SUITE 214
-----------------------------------------------------
City | AVON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81620-3387
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-748-1220
-----------------------------------------------------
Fax | 970-748-1255
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 3387
-----------------------------------------------------
City | AVON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81620-3387
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-748-1220
-----------------------------------------------------
Fax | 970-748-1255
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. FRANKLIN S CHOW
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 970-748-1220
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------