Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Integrated Dermatology of Northeast Missouri LLC

Organization Dermatology Physician · NPI 1992518658

Integrated Dermatology of Northeast Missouri LLC is a Dermatology Physician in Hannibal, Missouri. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

163 Medical Dr
Hannibal, MO 63401-6884
Phone: (573) 719-1818
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1992518658
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Queen — Authorized Official · (561) 231-2635
Other names Integrated Dermatology Of Northeast Missouri Llc
NPI enumeratedJanuary 28, 2025
Last updated in NPPESJanuary 28, 2025
Certification dateJanuary 28, 2025
Mailing address4700 Exchange Ct Ste 110, Boca Raton, FL 33431-4450

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