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FACIAL PLASTIC SURGERY & DERMATOLOGY PLLC NPI 1881030088


NPI Information

NPI: 1881030088
Provider Name: FACIAL PLASTIC SURGERY & DERMATOLOGY PLLC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

Address:
448 LEWIS HARGETT CIR
STE 240
LEXINGTON, KY
ZIP 40503
Phone: (859) 226-0206
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FACIAL PLASTIC SURGERY & 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. FACIAL PLASTIC SURGERY & DERMATOLOGY PLLC NPI is 1881030088. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

448 LEWIS HARGETT CIR
STE 240
LEXINGTON, KY
ZIP 40503-594
Phone: (859) 226-0206
Fax: (859) 226-0207

The provider's authorized official is Samuel Jack Pruden .
The authorized official title is Owner and has the following contact phone number (859) 226-0206.

The enumeration date for this NPI number is 5/14/2013 and was last updated on 8/27/2013.


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
1207N00000XDermatology34192KENTUCKYNo
2208200000XPlastic Surgery34192KENTUCKYNo
3207ND0101XDermatologyMOHS-Micrographic Surgery34192KENTUCKYYes

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
17100245900MEDICAIDKENTUCKY
2K001521MEDICARE PINKENTUCKY
3000000823139OTHERKENTUCKYANTHEM BCBS

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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