Organization
REGIONAL DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARAH L JENSEN M.D. (OWNER)
(636) 933-7600
Entity
Organization
Contact information
Practice address
1463 HIGHWAY 61, SUITE B, FESTUS, MO 63028-4109
(636) 933-7600
(636) 933-5900
Mailing address
1463 HIGHWAY 61, SUITE B, FESTUS, MO 63028-4109
(636) 933-7600
(636) 933-5900
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2006031051
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206872806
—
MO
Enumeration date
05/24/2010
Last updated
05/24/2010
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