# SUSAN D PURCELL MD DERMATOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Purcell Dermatology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871044735
- **Authorized official:** SUSAN D PURCELL MD (OWNER)
- **Authorized official phone:** (314) 985-8000

## Contact information

- **Practice address:** 969 N MASON RD STE 170, SAINT LOUIS, MO 63141-6387
- **Practice address phone:** (314) 888-5305
- **Mailing address:** 969 N MASON RD STE 170, SAINT LOUIS, MO 63141-6387
- **Mailing address phone:** (314) 985-8000
- **Mailing address fax:** (314) 985-8004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 2008007453 | MO | Yes |

## Other

- **Enumeration date:** 10/16/2016
- **Last updated:** 12/12/2016