Organization
ADVANCED CLINICAL DERMATOLOGY, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEIGH ANN CARTER M.D. (PRESIDENT/DERMATOLOGIST)
(859) 288-5004
Entity
Organization
Contact information
Practice address
1401 HARRODSBURG RD, SUITE C415, LEXINGTON, KY 40504-3751
(859) 288-5004
(859) 288-5007
Mailing address
1401 HARRODSBURG RD, SUITE C415, LEXINGTON, KY 40504-3751
(859) 288-5004
(859) 288-5007
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
40054
KY
363AM0700X
Medical Physician Assistant
PA602
KY
363L00000X
Nurse Practitioner
3688P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033189295
INDIVIDUAL NPI
KY
05
—
7100090760
—
KY
01
—
DN1298
RAILROAD MEDICARE
KY
Enumeration date
08/14/2007
Last updated
02/20/2017
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