Organization
ASSOCIATES IN DERMATOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JYOTI BURRUSS MD (PARTNER)
(502) 583-1749
Entity
Organization
Contact information
Practice address
3810 SPRINGHURST BLVD, SUITE 200, LOUISVILLE, KY 40241
(502) 583-1749
(502) 329-8184
Mailing address
3810 SPRINGHURST BLVD, SUITE 200, LOUISVILLE, KY 40241-6100
(502) 583-1749
(502) 329-8184
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0900X
Dermatopathology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000059426
ANTHEM
KY
05
—
100010640A
—
IN
05
—
65912032
—
KY
05
—
7100295380
—
KY
Enumeration date
07/30/2006
Last updated
07/15/2020
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