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Organization
KENTUCKY DERMATOLOGY AND SKIN CANCER CLINIC, PSC
Active
Organization
KENTUCKY DERMATOLOGY AND SKIN CANCER CLINIC, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYE FENSTERMAKER (PRACTICE MANAGER)
(859) 276-1511
Entity
Organization
Contact information
Practice address
177 BURT RD, LEXINGTON, KY 40503-2410
(859) 276-1511
(859) 276-3373
Mailing address
177 BURT RD, LEXINGTON, KY 40503-2410
(859) 276-1511
(859) 276-3373
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NULL
174400000X
Specialist
Primary
—
—
207N00000X
Dermatology Physician
—
NULL
207N00000X
Dermatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C16315
RR MEDICARE
KY
Enumeration date
05/01/2007
Last updated
08/27/2020
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