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MERCY CLINIC DERMATOLOGY LLC NPI 1033470745


NPI Information

NPI: 1033470745
Provider Name: MERCY CLINIC DERMATOLOGY LLC
Classification: Dermatology - 207N00000X
Entity Type: Organization
Address:
621 S NEW BALLAS RD
SUITE 597A
SAINT LOUIS, MO
ZIP 63141
Phone: (314) 251-2095
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MERCY CLINIC DERMATOLOGY LLC is a dermatology in Saint Louis, MO. The provider is a 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 dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. MERCY CLINIC DERMATOLOGY LLC NPI is 1033470745. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

621 S NEW BALLAS RD
SUITE 597A
SAINT LOUIS, MO
ZIP 63141-232
Phone: (314) 251-2095
Fax: (314) 251-2096

The provider's authorized official is John W. Hubert .
The authorized official title is President and has the following contact phone number (314) 251-1560.

The enumeration date for this NPI number is 5/30/2012 and was last updated on 3/4/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyMISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DT7966OTHERMISSOURIRAILROAD MEDICARE
21033470745MEDICAIDMISSOURI
3MA4173MEDICARE PINMISSOURI
4MA4174MEDICARE PINMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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