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DERMATOLOGY OFFICE PC NPI 1043462591


NPI Information

NPI: 1043462591
Provider Name: DERMATOLOGY OFFICE PC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 26D1098352

Address:
225 PHYSICIANS PARK STE 304
POPLAR BLUFF, MO
ZIP 63901
Phone: (573) 686-4750
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DERMATOLOGY OFFICE PC is a mohs-micrographic surgery dermatology in Poplar Bluff, MO. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. DERMATOLOGY OFFICE PC NPI is 1043462591. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

225 PHYSICIANS PARK STE 304
POPLAR BLUFF, MO
ZIP 63901-930
Phone: (573) 686-4750

The provider's authorized official is Lance F Yeoman .
The authorized official title is Owner/physician and has the following contact phone number (573) 686-4750.

The CLIA number assigned to this NPI record is 26D1098352 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/15/2008 and was last updated on 1/3/2024.


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
1207V00000XObstetrics & GynecologyNo
2207ND0101XDermatologyMOHS-Micrographic SurgeryYes

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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