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Organization

DERMATOLOGY ASSOCIATES OF KENTUCKY PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FERNANDO DE CASTRO M.D. (MANAGING PARTNER)
(859) 263-4444
Entity
Organization

Contact information

Practice address
250 FOUNTAIN CT, LEXINGTON, KY 40509-1888
(859) 263-4444
(859) 543-8867
Mailing address
250 FOUNTAIN CT, LEXINGTON, KY 40509-1888
(859) 263-4444
(859) 543-8867

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
65900391
KY
05
7100120610
KY
Enumeration date
11/07/2006
Last updated
01/07/2011
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