Organization
DERMATOLOGY SPECIALISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE J HOOKERMAN MD (PRESIDENT)
(314) 291-2588
Entity
Organization
Contact information
Practice address
12105 BRIDGETON SQUARE DRIVE, BRIDGETON, MO 63044-2616
(314) 291-2588
(314) 291-4104
Mailing address
12105 BRIDGETON SQUARE DRIVE, BRIDGETON, MO 63044-2616
(314) 291-2588
(314) 291-4104
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202820213
—
MO
Enumeration date
12/04/2006
Last updated
05/28/2008
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