| Organization Name: | CLAYTON DERMATOLOGY LLC |
| NPI Number: | 1336253095 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LUCIANN LISI HRUZA (PRESIDENT) |
| Mailing Address: | 6744 Clayton Rd Suite 210 Saint Louis |
| State: | MO US |
| Postal Code: | 631171637 |
| Phone Number: | 3146454500 |
| Fax Number: | 3146455907 |
| NPI Enumeration Date: | 08/19/2006 |
| NPI Last Update Date: | 12/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 100200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |