| Resolute Dermatology | |
|
6800 Hilltop Rd Ste 102 Shawnee KS 66226-3571 | |
| (913) 901-5001 | |
| Not Available |
| Full Name | Resolute Dermatology |
|---|---|
| Speciality | Dermatology |
| Location | 6800 Hilltop Rd Ste 102, Shawnee, Kansas |
| Authorized Official Name and Position | Daniel L Christiansen (SOLE PROPRIETOR) |
| Authorized Official Contact | 9409239960 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resolute Dermatology 7111 W 151st St Overland Park KS 66223-2231 Ph: (913) 901-5001 | Resolute Dermatology 6800 Hilltop Rd Ste 102 Shawnee KS 66226-3571 Ph: (913) 901-5001 |
| NPI Number | 1124624028 |
|---|---|
| Provider Enumeration Date | 12/07/2020 |
| Last Update Date | 01/29/2021 |
| Medicare PECOS PAC ID | 1557775533 |
|---|---|
| Medicare Enrollment ID | O20210203000473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124624028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | (* (Not Available)) | Primary |
| Provider Name | Elizabeth A Spenceri |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1588665509 PECOS PAC ID: 3072584887 Enrollment ID: I20040805000683 |
| Provider Name | Daniel Lawrence Christiansen |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1265695589 PECOS PAC ID: 4789828690 Enrollment ID: I20181114001756 |
| Provider Name | Julie Ann Green |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1184935256 PECOS PAC ID: 9436377876 Enrollment ID: I20181128001002 |
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