Organization
WEST KENTUCKY DERMATOLOGY, PSC
Active
Other names
West Kentucky Dermatology, PSC
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM F. SMITH III M.D (PRESIDENT)
(270) 821-0066
Entity
Organization
Contact information
Practice address
95 YMCA DR, MADISONVILLE, KY 42431-9035
(270) 821-0066
(270) 821-6580
Mailing address
95 YMCA DR STE 3, MADISONVILLE, KY 42431-9035
(270) 821-0066
(270) 821-6580
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65943334
—
KY
05
—
78904885
—
KY
05
—
95901203
—
KY
Enumeration date
05/28/2006
Last updated
01/23/2025
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