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DERMATOLOGY OF SOUTHERN KENTUCKY PLLC NPI 1326203142


NPI Information

NPI: 1326203142
Provider Name: DERMATOLOGY OF SOUTHERN KENTUCKY PLLC
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 18D1087494

Address:
85 TOWER CIR
SOMERSET, KY
ZIP 42503
Phone: (606) 772-3376
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DERMATOLOGY OF SOUTHERN KENTUCKY PLLC is a dermatology in Somerset, KY. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. DERMATOLOGY OF SOUTHERN KENTUCKY PLLC NPI is 1326203142. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

85 TOWER CIR
SOMERSET, KY
ZIP 42503-476
Phone: (606) 772-3376
Fax: (606) 677-0335

The provider's authorized official is Brian L Baker .
The authorized official title is Physician/owner and has the following contact phone number (606) 772-3376.

The CLIA number assigned to this NPI record is 18D1087494 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/21/2008 and was last updated on 3/28/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic Surgery39921KENTUCKYNo
2363A00000XPhysician AssistantPA1591KENTUCKYNo
3363L00000XNurse Practitioner5583PKENTUCKYNo
4207N00000XDermatology39921WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100713MEDICARE PINKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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