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EAST LOUISVILLE DERMATOLOGY PSC NPI 1255468872


NPI Information

NPI: 1255468872
Provider Name: EAST LOUISVILLE DERMATOLOGY, PSC
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 18D0706454

Address:
4912 US HIGHWAY 42
SUITE 208
LOUISVILLE, KY
ZIP 40222
Phone: (502) 426-9565
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EAST LOUISVILLE DERMATOLOGY, PSC is a dermatology in Louisville, 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. EAST LOUISVILLE DERMATOLOGY, PSC NPI is 1255468872. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4912 US HIGHWAY 42
SUITE 208
LOUISVILLE, KY
ZIP 40222-349
Phone: (502) 426-9565
Fax: (502) 425-3240

The provider's authorized official is Terrie S Williams .
The authorized official title is President and has the following contact phone number (502) 426-9565.

The CLIA number assigned to this NPI record is 18D0706454 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/28/2007 and was last updated on 8/22/2020.


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
1207N00000XDermatology24086KENTUCKYYes

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: 11/14/2023

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