QUINCY PHYSICIANS & SURGEONS CLINIC, SC (NPI# 1760641179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760641179 |
Entity Type | Organization |
Organization Name | QUINCY PHYSICIANS & SURGEONS CLINIC, SC |
Other Organization Name | QUINCY MEDICAL GROUP |
Practice Address |
163 Medical Dr Hannibal MO 63401-6884 |
Mailing Address |
1025 Maine St Quincy IL 62301-4038 |
Practice Telephone | 5732483900 |
Practice Fax Number | 5732483902 |
Mailing Telephone | 2172226550 |
Mailing Fax Number | 2172772253 |
Enumeration Date | 2008-06-02 |
Last Update Date | 2011-03-25 |
Authorized Official Name | PATTY WOERMAN (CREDENTIALING SPECIALIST) |
Authorized Official Telephone | 2172226550 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
2004009689 | MO | Allopathic & Osteopathic Physicians |
N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
2004009689 | MO | Allopathic & Osteopathic Physicians |
N | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
2004009689 | MO | Allopathic & Osteopathic Physicians |
N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
2004009689 | MO | Allopathic & Osteopathic Physicians |
N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
2004009689 | MO | Allopathic & Osteopathic Physicians |
N | 291U00000X | Clinical Medical Laboratory | 26D1096719 | MO | Laboratories |
Y | 207N00000X | Dermatology | 2004009689 | MO | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Quincy Medical Group | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
1144462490 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 1000 Central Street, Labelle, MO 63447 | 2009-04-01 |
1467426585 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 405 E State, Pleasant Hill, IL 62366-0427 | 2006-02-15 |
1356315899 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 320 North Madison, Pittsfield, IL 62363-1412 | 2006-02-13 |
1902870439 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 1100 E Outer Rd S Ste 4, Canton, MO 63435-1702 | 2006-02-13 |
1639711120 | Quincy Physicians & Surgeons Clinic, Sc | Clinical Medical Laboratory | 320 N Madison St, Pittsfield, IL 62363-1412 | 2019-10-16 |
1215497730 | Quincy Physicians & Surgeons Clinic, Sc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1025 Maine St, Quincy, IL 62301-4096 | 2019-03-21 |
1508356098 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 1603 Morgan St Ste 3, Keokuk, IA 52632-3433 | 2018-05-10 |
1790158087 | Quincy Physicians & Surgeons Clinic, Sc | Durable Medical Equipment & Medical Supplies | 100 Medical Dr, Hannibal, MO 63401-6877 | 2015-11-09 |
Street Address |
163 MEDICAL DR |
City | HANNIBAL |
State | MO |
Zip Code | 63401-6884 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679552350 | Linda M Cooke | Dermatology | 163 Medical Dr, Hannibal, MO 63401-6884 | 2006-01-11 |
1699262329 | Riverside Dermatology & Spa LLC | Clinic/Center | 163 Medical Dr, Hannibal, MO 63401-6884 | 2018-04-18 |
1508874736 | Kathleen E Haycraft | Nurse Practitioner | 163 Medical Dr, Hannibal, MO 63401-6884 | 2006-08-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255981064 | Amanda Lynn Jennings | Nurse Practitioner | Hannibal Clinic, 100 Medical Drive, Hannibal, MO 63401 | 2019-09-13 |
1316452295 | Hannibal Regional Healthcare System, Inc | Hospice Care, Community Based | 6401 Hwy Mm, Hannibal, MO 63401 | 2017-12-13 |
1932614351 | Sidney M Johnson | Counselor | 1221 Broadway St, Hannibal, MO 63401 | 2017-12-07 |
1316467210 | Jessica Baker | Counselor | 4355 Paris Gravel Road, Hannibal, MO 63401 | 2017-06-21 |
1346787066 | Hands Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17 Settlerstrail, Hannibal, MO 63401 | 2017-01-20 |
1134571672 | Pamela Barrigar | Social Worker | 4600 Mcmasters Ave, Hannibal, MO 63401 | 2016-07-08 |
1639540677 | Jessica Murfin | Speech-Language Pathologist | 544 N Veterans Rd, Hannibal, MO 63401 | 2015-10-16 |
1366835639 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 8965 Highway 36 Ste 3, Hannibal, MO 63401 | 2015-03-11 |
1639324254 | Hannibal Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 118 Steam Boat Bend, Hannibal, MO 63401 | 2008-11-24 |
1780856112 | Barbara Belle Smith | Social Worker | 3700 Hwy Mm, Hannibal, MO 63401 | 2008-03-26 |
Find all providers in zip 63401 |
Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
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. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679552350 | Linda M Cooke | Dermatology | 163 Medical Dr, Hannibal, MO 63401-6884 | 2006-01-11 |
1881673457 | Susan M Meidl | Dermatology | 100 Medical Dr, Hannibal, MO 63401-6877 | 2006-01-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922605906 | Deluxe Dermatology LLC | Dermatology | 1034 S Brentwood Blvd Ste 1000, Saint Louis, MO 63117-1210 | 2020-10-03 |
1811510886 | Yoon Dermatology LLC | Dermatology | 1060 Meyer Rd, Wentzville, MO 63385-3800 | 2020-05-25 |
1417597923 | Anna Marie Aiazzi | Dermatology | 10012 Kennerly Rd Ste 401, Saint Louis, MO 63128-2197 | 2020-01-13 |
1790330371 | Baydon Earl Hilton | Dermatology | 1003 Kings Rd, Kirksville, MO 63501-2627 | 2019-08-09 |
1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
1528537057 | Cayce Medical Spa, Inc | Dermatology | 2001 Corona Rd Ste 201, Columbia, MO 65203-5924 | 2018-11-14 |
1396226981 | Nicole Betty | Dermatology | 413 W Water Street, Greenfield, MO 65661 | 2018-08-22 |
1366946832 | Novahealth Medical Group, LLC | Dermatology | 3208 Lemone Industrial Blvd Ste A, Columbia, MO 65201-8244 | 2018-03-20 |
1952757007 | Stacy Gittel Blum | Dermatology | 222 S Woods Mill Rd Ste 480, Chesterfield, MO 63017-3625 | 2016-05-08 |
1508248576 | Kaitlin Ann Schiavo | Dermatology | 204 N Keene St Ste 100, Columbia, MO 65201-8136 | 2015-06-25 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.