Organization
MODERN DERMATOLOGY OF KENTUCKY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK COMBS (MANAGING PARTNER)
(859) 276-1511
Entity
Organization
Contact information
Practice address
161 LEXINGTON GREEN CIR STE 100, LEXINGTON, KY 40503-3801
(859) 276-1511
(859) 277-2556
Mailing address
169 BURT RD, LEXINGTON, KY 40503-2455
(859) 278-9242
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207N00000X
Dermatology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
09/24/2020
Last updated
08/26/2024
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