Organization
NORTHERN KENTUCKY DERMATOLOGY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM B HOPPENJANS M.D. (PRESIDENT)
(859) 341-1878
Entity
Organization
Contact information
Practice address
2701 CHANCELLOR DR, CRESTVIEW HILLS, KY 41017-5479
(859) 341-1878
(859) 341-0560
Mailing address
2701 CHANCELLOR DR, CRESTVIEW HILLS, KY 41017-5479
(859) 341-1878
(859) 341-0560
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
27789
KY
207N00000X
Dermatology Physician
31407
KY
207N00000X
Dermatology Physician
35.057303
OH
207ND0101X
MOHS-Micrographic Surgery Physician
31407
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB1814
RR MEDICARE
—
Enumeration date
09/19/2007
Last updated
09/17/2010
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