Organization
ELKHORN DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHASE WILSON MD (OWNER)
(502) 316-9425
Entity
Organization
Contact information
Practice address
304 BOSTON SQ, GEORGETOWN, KY 40324-9786
(502) 316-9425
(502) 316-9451
Mailing address
304 BOSTON SQ, GEORGETOWN, KY 40324-9786
(502) 316-9425
(502) 316-9451
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
49577
KY
207N00000X
Dermatology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/29/2017
Last updated
08/24/2020
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