Organization
PADUCAH DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HALDEN HEATH FORD MD (OWNER)
(270) 444-8477
Entity
Organization
Contact information
Practice address
3101 PARISA DR, PADUCAH, KY 42003
(270) 444-8477
(270) 444-8479
Mailing address
3101 PARISA DR, PADUCAH, KY 42003-4584
(270) 444-8477
(270) 444-8479
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
32680
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65940298
—
KY
Enumeration date
01/18/2007
Last updated
08/08/2018
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