Organization
DERMATOPATHOLOGY ALLIANCE OF KENTUCKY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL K FEARNEYHOUGH MD (PATHOLOGIST)
(502) 583-5834
Entity
Organization
Contact information
Practice address
839 S 2ND ST, LOUISVILLE, KY 40203-2209
(502) 456-6217
(502) 456-4440
Mailing address
1941 BISHOP LN STE 1018, LOUISVILLE, KY 40218-1928
(502) 456-6217
(502) 456-4440
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
KY
207N00000X
Dermatology Physician
—
KY
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000247638
ANTHEM BLUE CROSS BS
KY
05
—
000100269
—
VA
01
—
01895510
ANTHEM MA
KY
01
—
151583XX
PREFERRED CARE
—
05
—
200364970A
—
IN
05
—
2676260
—
OH
01
—
277243
ANTHEM BCBS MC SUPP
VA
01
—
30004761050
CARESOURCE
KY
05
—
3103049
—
NH
05
—
4409994
—
TN
01
—
50115665
PASSPORT
KY
01
—
5115678
AETNA
KY
01
—
611948800
US DEPT LABOR DEEOIC
KY
01
—
611948801
US DEPT LABOR BLACK LUNG
KY
05
—
6701094-000
—
WV
01
—
690009345
RAILROAD MEDICARE
—
05
—
7100173900
—
KY
01
—
78469
AETNA BETTER HEALTH
KY
01
—
93434
HEALTH PARTNERS
—
01
—
BP87-0001
BC/BS MD
MD
Enumeration date
08/15/2006
Last updated
02/19/2021
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