INTEGRATED DERMATOLOGY OF NORTHEAST MISSOURI LLC
NPI 1992518658
Dermatology in Hannibal, MO

Active since January 28, 2025
163 MEDICAL DR, HANNIBAL, MO 63401(573) 719-1818 Get Directions Write a Review

NPPES record last updated: January 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Integrated Dermatology Of Northeast Missouri Llc NPPES

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

INTEGRATED DERMATOLOGY OF NORTHEAST MISSOURI LLC (NPI 1992518658) is a healthcare organization registered as a dermatology in Hannibal, Missouri and active in the NPI registry since January 2025. The organization lists Jeffrey Queen, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1992518658
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINTEGRATED DERMATOLOGY OF NORTHEAST MISSOURI LLC
Location Address163 MEDICAL DRHannibal, MO 63401-6884
Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000
Organization SubpartNo
Authorized OfficialJeffrey QueenAuthorized Official · (561) 231-2635
Enumeration DateJanuary 28, 2025
NPPES CertifiedJanuary 28, 2025
NPI 1992518658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
163 MEDICAL DR, Hannibal, MO 63401

Other Names 1

Former Legal Business NameIntegrated Dermatology Of Northeast Missouri Llc

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 6

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

Nurse Practitioner
163 MEDICAL DR
HANNIBAL, MO 63401
Nurse Practitioner
163 MEDICAL DR
HANNIBAL, MO 63401
Dermatology (MOHS-Micrographic Surgery)
163 MEDICAL DR
HANNIBAL, MO 63401
Nurse Practitioner
163 MEDICAL DR
HANNIBAL, MO 63401
Dermatology
163 MEDICAL DR
HANNIBAL, MO 63401
Clinic/Center (Multi-Specialty)
163 MEDICAL DR
HANNIBAL, MO 63401

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 Integrated Dermatology Of Northeast Missouri LLC's NPI number?

The NPI number for Integrated Dermatology Of Northeast Missouri LLC is 1992518658. It was assigned to this organization in the NPPES registry on January 28, 2025.

Where is Integrated Dermatology Of Northeast Missouri LLC located?

Integrated Dermatology Of Northeast Missouri LLC is located at 163 Medical Dr, Hannibal, MO 63401. The listed phone number is (573) 719-1818.

What is Integrated Dermatology Of Northeast Missouri LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

When was this NPI record last updated?

The NPPES record for Integrated Dermatology Of Northeast Missouri LLC was last updated on January 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.