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General NPI Number Information
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NPI Number | 1306662200
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Entity Type | Organization
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Legal Business Name | PRECISION SKIN CARE DERMATOLOGY, LLC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 10287 CLAYTON RD STE 360
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City | SAINT LOUIS
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State | MO
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Zip | 63124-1181
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Country | US
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Telephone | 314-350-8207
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Fax | 314-293-6801
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Provider Business Mailing Address
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Address Line | 10287 CLAYTON RD STE 360
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City | SAINT LOUIS
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State | MO
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Zip | 63124-1181
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Country | US
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Telephone | 314-350-8207
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Fax | 314-293-6801
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. ELIZABETH ANNE RANCOUR
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Credential | MD
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Telephone | 314-350-8207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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