Provider Demographics
NPI:1932326774
Name:CENTRAL DERMATOLOGY, P.C.
Entity Type:Organization
Organization Name:CENTRAL DERMATOLOGY, P.C.
Other - Org Name:CRAIG L. LEONARDI, M.D., P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEONARDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-721-5565
Mailing Address - Street 1:1034 S BRENTWOOD BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1206
Mailing Address - Country:US
Mailing Address - Phone:314-721-5565
Mailing Address - Fax:314-721-6122
Practice Address - Street 1:1034 S BRENTWOOD BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1206
Practice Address - Country:US
Practice Address - Phone:314-721-5565
Practice Address - Fax:314-721-6122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty