PREMIER DERMATOLOGY LLC NPI 1699169086

NPI Information

  • NPI: 1699169086
  • Provider Name: PREMIER DERMATOLOGY LLC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 26D2081535
  • Address: 456 N NEW BALLAS RD
    SUITE 118
    SAINT LOUIS, MO
    ZIP 63141
  • Phone: (314) 567-1400

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NPI Details

PREMIER DERMATOLOGY LLC is a specialist in Saint Louis, MO. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PREMIER DERMATOLOGY LLC NPI is 1699169086. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

456 N NEW BALLAS RD
SUITE 118
SAINT LOUIS, MO
ZIP 63141-831
Phone: (314) 567-1400
Fax: (314) 567-9559

The provider's authorized official is Jeff T Reed .
The authorized official title is Owner and has the following contact phone number (314) 567-1400.

The CLIA number assigned to this NPI record is 26D2081535 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/24/2015 and was last updated on 3/24/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistMISSOURIYes

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: 3/30/2025

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