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Organization

MERCY CLINIC DERMATOLOGY LLC

Active
Parent organization
MERCY CLINIC EAST COMMUNITIES
Organization subpart
Yes

Provider details

NPI number
Legal business name
MERCY CLINIC EAST COMMUNITIES
Authorized official
JONATHAN TYLER STURGEON (CFO)
(314) 251-1917
Entity
Organization

Contact information

Practice address
901 PATIENTS FIRST DR STE 3600, WASHINGTON, MO 63090-4700
(636) 390-1595
(636) 390-1596
Mailing address
901 PATIENTS FIRST DR STE 3600, WASHINGTON, MO 63090-4700
(636) 390-1595
(636) 390-1596

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1033470745
MO
01
DT7966
RAILROAD MEDICARE
MO
Enumeration date
05/30/2012
Last updated
02/19/2026
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