Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Integrated Dermatology of Ponchatoula, LLC

Organization Dermatology Physician · NPI 1508234600

Integrated Dermatology of Ponchatoula, LLC provides Dermatology Physician services in Ponchatoula, Louisiana. Registered with an NPI since 2015.

In the registry since
2015
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

180 N 5th St
Ponchatoula, LA 70454-2532
Phone: (985) 370-7546
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1508234600
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Queen — Manager · (561) 314-2000
NPI enumeratedSeptember 4, 2015
Last updated in NPPESMay 21, 2019
Mailing address4700 Exchange Ct Ste 110, Boca Raton, FL 33431-4450

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