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BOWLING GREEN DERMATOLOGY & SKIN CANCER SPECIALISTS PLLC NPI 1609047083


NPI Information

NPI: 1609047083
Provider Name: BOWLING GREEN DERMATOLOGY & SKIN CANCER SPECIALISTS PLLC
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 18D1089269

Address:
1106 FAIRWAY STREET
BOWLING GREEN, KY
ZIP 42103
Phone: (615) 672-5953
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BOWLING GREEN DERMATOLOGY & SKIN CANCER SPECIALISTS PLLC is a dermatology in Bowling Green, 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. BOWLING GREEN DERMATOLOGY & SKIN CANCER SPECIALISTS PLLC NPI is 1609047083. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1106 FAIRWAY STREET
BOWLING GREEN, KY
ZIP 42103
Phone: (615) 672-5953
Fax: (615) 672-5953

The provider's authorized official is John Davis Cowan .
The authorized official title is Owner and has the following contact phone number (615) 672-5953.

The CLIA number assigned to this NPI record is 18D1089269 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/13/2008 and was last updated on 9/30/2008.


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
1207N00000XDermatology41690KENTUCKYYes

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
100663MEDICARE 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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