Organization
PHYSICIANS SKIN CARE PLLC
Active
Other names
PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEON KIRCIK MD (OWNER SOLE PROPRIETOR)
(502) 451-9000
Entity
Organization
Contact information
Practice address
1169 EASTERN PARKWAY, SUITE #2310, LOUISVILLE, KY 40217
(502) 451-9000
(502) 456-2728
Mailing address
1169 EASTERN PARKWAY, SUIT #2310, LOUISVILLE, KY 40217
(502) 451-9000
(502) 456-2728
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000216151
ANTHEM
KY
05
—
1156019
—
KY
01
—
CJ6680
MEDICARE RAILROAD PALMETT
—
Enumeration date
12/14/2007
Last updated
08/13/2019
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