Organization
INTEGRATED DERMATOLOGY OF NORTHEAST MISSOURI LLC
Active
Other names
Integrated Dermatology of Northeast Missouri LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY QUEEN (AUTHORIZED OFFICIAL)
(561) 231-2635
Entity
Organization
Contact information
Practice address
163 MEDICAL DR, HANNIBAL, MO 63401-6884
(573) 719-1818
Mailing address
4700 EXCHANGE CT STE 110, BOCA RATON, FL 33431-4450
(561) 314-2000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
01/28/2025
Last updated
01/28/2025
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