Organization
COLUMBIA DERMATOLOGY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDALL A. PERRY M.D. (PRESIDENT)
(573) 876-1616
Entity
Organization
Contact information
Practice address
401 N KEENE ST, COLUMBIA, MO 65201-6625
(573) 876-1616
(573) 876-1678
Mailing address
401 N KEENE ST, COLUMBIA, MO 65201-6625
(573) 876-1616
(573) 876-1678
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
107883
MO
207ND0101X
MOHS-Micrographic Surgery Physician
107883
MO
Other
Enumeration date
10/03/2006
Last updated
09/05/2012
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