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SKIN SURGERY CENTER OF MISSOURI LLC NPI 1760662514


NPI Information

NPI: 1760662514
Provider Name: SKIN SURGERY CENTER OF MISSOURI, LLC
Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

CLIA Number: 26D1076758

Address:
6704 KEATON CORPORATE PKWY STE 100
O FALLON, MO
ZIP 63368
Phone: (636) 300-9596
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SKIN SURGERY CENTER OF MISSOURI, LLC is a procedural dermatology dermatology in O Fallon, MO. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). SKIN SURGERY CENTER OF MISSOURI, LLC NPI is 1760662514. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6704 KEATON CORPORATE PKWY STE 100
O FALLON, MO
ZIP 63368-680
Phone: (636) 300-9596
Fax: (636) 300-9598

The provider's authorized official is Saadia Taufiq Raza .
The authorized official title is Director and has the following contact phone number (314) 276-0385.

The CLIA number assigned to this NPI record is 26D1076758 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 11/9/2007 and was last updated on 1/11/2021.


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
1207NS0135XDermatologyProcedural DermatologyMISSOURIYes

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: 5/5/2024

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