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ST CHARLES COUNTY DERMATOLOGIC SURGERY, LLC
NPI 1235761438
Dermatology - Procedural Dermatology in Cottleville, MO

Active since February 06, 2020
1493 COTTLEVILLE PKWY, COTTLEVILLE, MO 63376(636) 317-3376(636) 244-1197 Get Directions Write a Review

NPPES record last updated: February 6, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About St Charles County Dermatologic Surgery, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST CHARLES COUNTY DERMATOLOGIC SURGERY, LLC (NPI 1235761438) is a healthcare organization registered as a procedural dermatology in Cottleville, Missouri and active in the NPI registry since February 2020. The organization lists Stacey S Tull, Physician And Owner, as its authorized official.

NPPES Registry Identity

NPI1235761438
Entity TypeOrganization
Primary Taxonomy207NS0135X
Legal Business NameST CHARLES COUNTY DERMATOLOGIC SURGERY, LLC
Location Address1493 COTTLEVILLE PKWYCottleville, MO 63376-3564
Mailing Address1493 Cottleville PkwyCottleville, MO 63376-3564 · (636) 317-3376 · Fax (636) 244-1197
Phone(636) 317-3376
Fax(636) 244-1197
Organization SubpartNo
Authorized OfficialStacey S TullPhysician And Owner · (636) 327-3376
Enumeration DateFebruary 6, 2020
✔ NPI 1235761438 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
Definition
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
1493 COTTLEVILLE PKWY, Cottleville, MO 63376
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STACEY S TULL MD
Dermatology
1493 COTTLEVILLE PKWY
COTTLEVILLE, MO 63376
St. Charles County (636) 317-3376
MORGAN M SCHROER PHYSICIAN ASSISTANT
Physician Assistant
1493 COTTLEVILLE PKWY
SAINT PETERS, MO 63376
St. Charles County (636) 317-3376

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St Charles County Dermatologic Surgery, LLC's NPI number?

The NPI number for St Charles County Dermatologic Surgery, LLC is 1235761438. It was assigned to this organization in the NPPES registry on February 6, 2020.

Where is St Charles County Dermatologic Surgery, LLC located?

St Charles County Dermatologic Surgery, LLC is located at 1493 Cottleville Pkwy, Cottleville, MO 63376. The listed phone number is (636) 317-3376.

What is St Charles County Dermatologic Surgery, LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

When was this NPI record last updated?

The NPPES record for St Charles County Dermatologic Surgery, LLC was last updated on February 6, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.