Organization
DERMATOLOGY OF SOUTHERN KENTUCKY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN L BAKER MD (PHYSICIAN/OWNER)
(606) 772-3376
Entity
Organization
Contact information
Practice address
85 TOWER CIR, SOMERSET, KY 42503-3476
(606) 772-3376
(606) 677-0335
Mailing address
85 TOWER CIR, SOMERSET, KY 42503-3476
(606) 772-3376
(606) 677-0335
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
39921
KY
207ND0101X
MOHS-Micrographic Surgery Physician
39921
KY
363A00000X
Physician Assistant
PA1591
KY
363L00000X
Nurse Practitioner
5583P
KY
Other
Enumeration date
07/21/2008
Last updated
03/28/2012
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