Dermatology and Mohs Surgery Center LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY AND MOHS SURGERY CENTER LLC

Practice address

12139 Panama City Beach Pkwy
Panama City, FL 32407-2609

Phone

(417) 336-0033

Fax

(855) 710-6552

NPI assigned

Oct 9, 2023

Last updated

Oct 10, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Leone, MDNPI 1255523296

Title

Owner

Phone

(417) 336-0033

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Douglas Michael Leone, M.D.

  • Dermatology Physician
  • Branson, MO
  • NPI 1255523296
  NPD Authorized official

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1679354393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BUSINESS PARK DR STE C",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167449",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12139 PANAMA CITY BEACH PKWY",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324072609",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY AND MOHS SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "LEONE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-336-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Clay Denecke, CRNA
• Marla Gail Denecke, ARNP
• Forrest Ed Dennis, LMHC
• Wesley Addison Dent, DMD
• William W Dent, MD
• Dermatology Associates of Bay County (Pathology Services of America Division of Dermatology Associates of Ba)
• Dermatology Associates of Bay County, P.a.
• Cyril Chitta Desilva, M.D.
• Anita B. Desonia, MS, LMHC
• Emma Renee Devine, RBT

• Dermatology Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.