Organization
LOUISVILLE DERMATOLOGY ASC PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN THOMAS LOGSDON MD (DERMATOLOGIST OWNER)
(502) 363-1841
Entity
Organization
Contact information
Practice address
1700 BLUEGRASS AVENUE, SUITE 300, LOUISVILLE, KY 40215
(502) 363-1841
(502) 366-3317
Mailing address
1700 BLUEGRASS AVENUE, SUITE 300, LOUISVILLE, KY 40215
(502) 363-1841
(502) 366-3317
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50005707
PASSPORT
—
05
—
65943797
—
KY
Enumeration date
01/02/2007
Last updated
12/02/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up