# KY DERMATOLOGY & SKIN CANCER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659542058
- **Authorized official:** DR. CLIFTON SMITH MD (OWNER)
- **Authorized official phone:** (859) 276-1511

## Contact information

- **Practice address:** 1750 HIGHWAY 192 W, LONDON, KY 40741-2639
- **Practice address phone:** (859) 276-1511
- **Practice address fax:** (859) 276-3373
- **Mailing address:** 177 BURT RD, LEXINGTON, KY 40503-2457
- **Mailing address phone:** (859) 276-1511
- **Mailing address fax:** (859) 276-3373

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | Yes |
| 174400000X | Specialist | — | — | Yes |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |

## Other

- **Enumeration date:** 03/13/2008
- **Last updated:** 08/21/2020