Mercy Clinic Dermatology Llc

LBN: Mercy Clinic Dermatology Llc
Mercy Clinic Dermatology Llc is an health care organization with primary practice located at 621 S New Ballas Rd Suite 597A, Saint Louis MO 63141-8232. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Mercy Clinic Dermatology Llc can be contacted via phone (314) 251-2095, or through Hubert, John W. via phone (314) 251-1560.

Contact Information

Primary practice address
621 S New Ballas Rd Suite 597A Saint Louis MO 63141-8232
Phone: (314) 251-2095
Fax: (314) 251-2096
Website:
Map and Directions
Authorized official contact:
Name: Hubert, John W. Doctor of Medicine (MD)
Phone: (314) 251-1560

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X Missouri

Profile Details

NPI number 1033470745
LBN Legal business name Mercy Clinic Dermatology Llc
DBA Doing business as
Authorized official Hubert, John W. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date May 30th, 2012
Last updated Mar 4th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033470745 NPPES
Missouri MEDICAID 1033470745
Missouri Other DT7966

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