Clayton Dermatology LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

100200 Issued in MO

Legal business name

CLAYTON DERMATOLOGY LLC

Practice address

816 S Kirkwood Rd Ste 210
Saint Louis, MO 63122-6056

Phone

(314) 645-4500

Fax

(314) 645-5907

NPI assigned

Aug 19, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Luciann Lisi Hruza, MD

Title

President

Phone

(314) 645-4500

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1336253095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 S KIRKWOOD RD STE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226056",
            "telephone_number": "314-645-4500",
            "fax_number": "314-645-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 S KIRKWOOD RD STE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226056",
            "telephone_number": "314-645-4500",
            "fax_number": "314-645-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "HRUZA",
        "authorized_official_first_name": "LUCIANN",
        "authorized_official_middle_name": "LISI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-645-4500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MO",
            "license": "100200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miton Shatorey Clayborn
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• Clayton Chiropractic Medicine
• Clayton Chiropractic Medicine Inc
• Clayton Endocrinology LLC
• Clayton Medical Associates, P.C.
• Clayton Medical Center
• Clayton Medical Center, LLC
• Clayton Medical Consultants Inc

• Specialist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.