Dermatology Specialists, Psc

LBN: Dermatology Specialists, Psc
Dermatology Specialists, Psc is an health care organization with primary practice located at 501 S 2Nd St First Floor, Louisville KY 40202-2862. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty. Dermatology Specialists, Psc can be contacted via phone (502) 583-7546, or through Jackson, J. Mark via phone (502) 583-7546.

Contact Information

Primary practice address
501 S 2Nd St First Floor Louisville KY 40202-2862
Phone: (502) 583-7546
Fax: (502) 589-3429
Website:
Map and Directions
Authorized official contact:
Name: Jackson, J. Mark Doctor of Medicine (MD)
Phone: (502) 583-7546

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Allopathic & Osteopathic Physicians / Dermatology 207N00000X Kentucky

Profile Details

NPI number 1013069301
LBN Legal business name Dermatology Specialists, Psc
DBA Doing business as
Authorized official Jackson, J. Mark Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 17th, 2007
Last updated Jan 17th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013069301 NPPES
Other CA7485 RRR MEDICARE
MEDICAID 200044790B RRR MEDICARE
Other 2433273000 RRR MEDICARE
Other 1052384 RRR MEDICARE

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