Organization
DERMATOLOGY ASSOCIATES OF KENTUCKY, PSC
Active
Other names
Dermatopathology Reference Lab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FERNANDO DE CASTRO M.D. (MEDICAL DIRECTOR)
(859) 263-4444
Entity
Organization
Contact information
Practice address
250 FOUNTAIN CT, LEXINGTON, KY 40509-1888
(859) 263-4444
(859) 543-8867
Mailing address
250 FOUNTAIN CT, LEXINGTON, KY 40509-1888
(859) 263-4444
(859) 543-8867
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
200197
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000179530
ANTHEM BLUE CROSS & BLUE SHIELD
KY
01
—
0350069
UNITED HEALTHCARE
KY
05
—
37000163
—
KY
01
—
C03011
CUMBERLAND HEALTHCARE
—
Enumeration date
02/14/2007
Last updated
08/02/2022
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