NPI age
17 years
Enumerated 2009-03-27
● Active Type 2 · Organization
Stoddard Medical, Inc
Stoddard Medical, Inc is 1 of 102 dermatology organizations in Idaho.
Primary specialty
Dermatology
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Stoddard
Owner/physician
Last NPPES update
2012-04-04
Source: monthly bulk 2026-05
How this organization compares
Across 102 active dermatology providers in Idaho.
NPI age
17 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-03Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
147 W Chubbuck Rd
Chubbuck, ID 832022314
Mailing address
147 W Chubbuck Rd
Chubbuck, ID 832022314
Authorized official
Earl R Stoddard, M.D.
Owner/physician
📞 2082387546
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Trevor Batty, D.O. Dermatology NPI 1558756106
- Leslie Burnside, PA-C Physician Assistant NPI 1760451454
- Ryan McCulloch, PA Physician Assistant NPI 1720195530
- Amy McKinlay, PA-C Physician Assistant NPI 1992716674
- Earl Stoddard, M.D. Dermatology NPI 1760400238
Specialties
-
Dermatology PrimaryA dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 11311121 | MEDICARE PTAN |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Idaho Skin Institute, Inc.
Practice context
Multi-provider organization. 5 individual providers on file at this primary address.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.