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SUSAN D PURCELL MD DERMATOLOGY LLC NPI 1871044735


NPI Information

NPI: 1871044735
Provider Name: SUSAN D PURCELL MD DERMATOLOGY LLC

Doing Business As: PURCELL DERMATOLOGY

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

CLIA Number: 26D2122443

Address:
969 N MASON RD STE 170
SAINT LOUIS, MO
ZIP 63141
Phone: (314) 888-5305
Get Directions

SUSAN D PURCELL MD DERMATOLOGY LLC is a medical specialty clinic center in Saint Louis, MO. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). SUSAN D PURCELL MD DERMATOLOGY LLC NPI is 1871044735. The provider is registered as an organization entity type.
The provider Is Doing Business As Purcell Dermatology.

The provider's business location address is:

969 N MASON RD STE 170
SAINT LOUIS, MO
ZIP 63141-387
Phone: (314) 888-5305

The provider's authorized official is Susan D Purcell .
The authorized official title is Owner and has the following contact phone number (314) 985-8000.

The CLIA number assigned to this NPI record is 26D2122443 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/16/2016 and was last updated on 12/12/2016.


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
1261QM2500XClinic/CenterMedical Specialty2008007453MISSOURIYes

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
11831244904OTHERNPI

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: 11/14/2023

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