DERMATOPATHOLOGY ALLIANCE OF KENTUCKY PLLC NPI 1548273733

NPI Information

NPI: 1548273733
Provider Name: DERMATOPATHOLOGY ALLIANCE OF KENTUCKY PLLC
Classification: Pathology - 207ZD0900X
Entity Type: Organization

Specialization: Dermatopathology

CLIA Number: 18D0997022

Address:
839 S 2ND ST
LOUISVILLE, KY
ZIP 40203
Phone: (502) 456-6217
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DERMATOPATHOLOGY ALLIANCE OF KENTUCKY PLLC is a dermatopathology pathology in Louisville, KY. The provider is a dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. DERMATOPATHOLOGY ALLIANCE OF KENTUCKY PLLC NPI is 1548273733. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

839 S 2ND ST
LOUISVILLE, KY
ZIP 40203-209
Phone: (502) 456-6217
Fax: (502) 456-4440

The provider's authorized official is Paul K Fearneyhough .
The authorized official title is Pathologist and has the following contact phone number (502) 583-5834.

The CLIA number assigned to this NPI record is 18D0997022 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/15/2006 and was last updated on 2/19/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	1223P0106X	Dentist	Oral and Maxillofacial Pathology	KENTUCKY	No
2	207N00000X	Dermatology		KENTUCKY	No
3	207ZP0102X	Pathology	Anatomic Pathology & Clinical Pathology		No
4	207ZD0900X	Pathology	Dermatopathology		Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000000247638	OTHER	KENTUCKY	ANTHEM BLUE CROSS BS
2	151583XX	OTHER		PREFERRED CARE
3	2676260	MEDICAID	OHIO
4	5115678	OTHER	KENTUCKY	AETNA
5	611948800	OTHER	KENTUCKY	US DEPT LABOR DEEOIC
6	000100269	MEDICAID	VIRGINIA
7	30004761050	OTHER	KENTUCKY	CARESOURCE
8	93434	OTHER		HEALTH PARTNERS
9	BP87-0001	OTHER	MARYLAND	BC/BS MD
10	3103049	MEDICAID	NEW HAMPSHIRE
11	277243	OTHER	VIRGINIA	ANTHEM BCBS MC SUPP
12	50115665	OTHER	KENTUCKY	PASSPORT
13	690009345	OTHER		RAILROAD MEDICARE
14	78469	OTHER	KENTUCKY	AETNA BETTER HEALTH
15	200364970A	MEDICAID	INDIANA
16	611948801	OTHER	KENTUCKY	US DEPT LABOR BLACK LUNG
17	6701094-000	MEDICAID	WEST VIRGINIA
18	01895510	OTHER	KENTUCKY	ANTHEM MA
19	7100173900	MEDICAID	KENTUCKY
20	4409994	MEDICAID	TENNESSEE

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

NPI Synchronization or Removal

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