Organization
DERMATOLOGY AND MOHS SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS LEONE MD (OWNER)
(417) 336-0033
Entity
Organization
Contact information
Practice address
12139 PANAMA CITY BEACH PKWY, PANAMA CITY, FL 32407-2609
(417) 336-0033
(855) 710-6552
Mailing address
110 BUSINESS PARK DR STE C, BRANSON, MO 65616-7449
(417) 336-0033
(855) 710-6552
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
10/09/2023
Last updated
10/10/2023
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