Facial Plastic Surgery & Dermatology Pllc

LBN: Facial Plastic Surgery & Dermatology Pllc
Facial Plastic Surgery & Dermatology Pllc is an health care organization with primary practice located at 448 Lewis Hargett Cir Ste 240, Lexington KY 40503-3594. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is the primary health care specialty. Facial Plastic Surgery & Dermatology Pllc can be contacted via phone (859) 226-0206, or through Pruden, Samuel Jack via phone (859) 226-0206.

Contact Information

Primary practice address
448 Lewis Hargett Cir Ste 240 Lexington KY 40503-3594
Phone: (859) 226-0206
Fax: (859) 226-0207
Website:
Map and Directions
Authorized official contact:
Name: Pruden, Samuel Jack Doctor of Medicine (MD)
Phone: (859) 226-0206

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 34192 Kentucky
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 34192 Kentucky
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 34192 Kentucky

Profile Details

NPI number 1881030088
LBN Legal business name Facial Plastic Surgery & Dermatology Pllc
DBA Doing business as
Authorized official Pruden, Samuel Jack Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 14th, 2013
Last updated Aug 27th, 2013 - 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 1881030088 NPPES
Kentucky Other 000000823139 ANTHEM BCBS
Kentucky MEDICAID 7100245900 ANTHEM BCBS

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