Lake Loveland Dermatology PC
Organization Active NPI Dermatology Physician · Estes Park, CO
NPI 1265033138 · NPPES record last updated Jan 19, 2021
Key facts
- NPI
- 1265033138
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- LAKE LOVELAND DERMATOLOGY PC
- Practice address
- 555 Prospect Ave
Estes Park, CO 80517-6312 - Phone
- (970) 667-3119
- Fax
- (970) 669-0159
- NPI assigned
- Nov 5, 2020
- Organization subpart
- No
Authorized official
- Name
- Kevin John Mott
- Title
- Owner
- Phone
- (303) 569-7700
Corporate family (same tax ID) 2
Practitioners 1
-
Kevin John Mott, MD
National Provider Directory
- Tax ID family
- Lake Loveland Dermatology PC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes | ||
| MOHS-Micrographic Surgery Physician |
207ND0101X | |||
| Dermatopathology Physician |
207ND0900X | |||
| Procedural Dermatology Physician |
207NS0135X |
Addresses
Primary practice location
555 Prospect Ave
Estes Park, CO 80517-6312
Mailing address
PO Box 7643
Loveland, CO 80537-0643
Phone (970) 663-2742
Other providers in Estes Park, CO
- Sandy Kaiser
- Nancy Karr
- Steven Leslie Keller
- Kristine G. Musick, PH.D., LLC
- Meemee Lahman
- Christopher Lamar
- Larimer County School District R-3
- Ronald Gregory Legge
- Life Rhythms
- Marybeth Lisse
All providers in Estes Park, CO · Dermatology Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.