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

Rolla Dermatology LLC

Organization Medical Physician Assistant · NPI 1619714425

Rolla Dermatology LLC is a Medical Physician Assistant in Rolla, Missouri. Registered with an NPI since 2024.

In the registry since
2024
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

1312 E State Hwy 72
Rolla, MO 65401-3939
Phone: (573) 426-4112
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1619714425
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Darrin Taylor — Manager · (417) 766-2043
NPI enumeratedJuly 9, 2024
Last updated in NPPESJuly 22, 2024
Certification dateJuly 22, 2024
Mailing address13109 Sterling Hills Dr, Rolla, MO 65401-6644

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