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:
Authorized official contact:
Name: Pruden, Samuel Jack Doctor of Medicine (MD)
Phone: (859) 226-0206
Health care specialties
| Specialty | Code | License # | 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 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881030088 | NPPES |
| Kentucky | Other | 000000823139 | ANTHEM BCBS |
| Kentucky | MEDICAID | 7100245900 | ANTHEM BCBS |
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