Organization
SKINMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL PRUDEN MD (PRESIDENT)
(859) 276-7546
Entity
Organization
Contact information
Practice address
989 GOVERNORS LN, SUITE 220, LEXINGTON, KY 40513-1173
(859) 296-7546
(513) 672-3323
Mailing address
200 NORTHLAND BLVD, 1ST FLOOR, CINCINNATI, OH 45246-3604
(513) 672-4111
(513) 672-4468
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Enumeration date
04/16/2014
Last updated
07/16/2014
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