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REGIONAL DERMATOLOGY PLLC NPI 1255851200


NPI Information

NPI: 1255851200
Provider Name: REGIONAL DERMATOLOGY PLLC

Doing Business As: SKIN MD

Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 18D2136302

Address:
989 GOVERNORS LN STE 220
LEXINGTON, KY
ZIP 40513
Phone: (859) 296-7546
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REGIONAL DERMATOLOGY PLLC is a mohs-micrographic surgery dermatology in Lexington, KY. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. REGIONAL DERMATOLOGY PLLC NPI is 1255851200. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Skin Md.

The provider's business location address is:

989 GOVERNORS LN STE 220
LEXINGTON, KY
ZIP 40513-175
Phone: (859) 296-7546
Fax: (859) 721-0829

The provider's authorized official is Samuel J Pruden .
The authorized official title is President and has the following contact phone number (859) 296-7546.

The CLIA number assigned to this NPI record is 18D2136302 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/21/2017 and was last updated on 10/30/2019.


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
1207ND0900XDermatologyDermatopathology34192KENTUCKYNo
2207Y00000XOtolaryngology34192KENTUCKYNo
3208200000XPlastic Surgery34192KENTUCKYNo
4363AM0700XPhysician AssistantMedicalNo
5207ND0101XDermatologyMOHS-Micrographic Surgery34192KENTUCKYYes

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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