JACK FOSTER DITTY JR. (NPI# 1740315589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740315589 |
| Entity Type | Individual |
| Full Name | JACK FOSTER DITTY JR. |
| Credential | M.D. |
| Practice Address |
100 Saint Christopher Dr Ashland KY 41101-7016 |
| Practice Telephone | 6068363111 |
| Practice Fax Number | 6068335660 |
| Mailing Telephone | 6068363111 |
| Mailing Fax Number | 6068335660 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2011-04-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
20687 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | MEDICAL LICENSE | 20687 | 01 |
| KY | 64206873 | 05 | |
| KY | DEA # | AD9266823 | 01 |
| OH | 024 1170 | 05 | |
| KY | ANTHEM PROVIDER # | 000000048343 | 01 |
| KY | TAX ID | 611053554 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043390925 | Jack F Ditty IIi | Emergency Medicine | 101 Stadium Drive, Morgantown, WV 26505 | 2006-10-16 |
| Street Address |
100 SAINT CHRISTOPHER DR |
| City | ASHLAND |
| State | KY |
| Zip Code | 41101-7016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386999787 | Jack F. Ditty, Md, Psc | Dermatology | 100 Saint Christopher Dr, Ashland, KY 41101-7016 | 2012-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588217947 | Aim Wellness LLC | Family Medicine | 844 Central Avenue, Ashland, KY 41101 | 2019-07-24 |
| 1306309067 | Ccc Management, LLC | Durable Medical Equipment & Medical Supplies | 1237 Carter Ave, Ashland, KY 41101 | 2019-04-10 |
| 1366925505 | Samantha Manci | Pharmacist | 2201 Lexington Ashland, Ashalnd, KY 41101 | 2018-09-13 |
| 1174068662 | Lea Ann Reeves-gollihue | Counselor | 1701 Central Ave., Ste. 250, Ashland, KY 41101 | 2016-12-20 |
| 1245786078 | Lindsay Marie Hagerman | Respiratory Therapist, Registered | 2413 Bradley Drive, Ashland, KY 41101 | 2016-08-31 |
| 1033572540 | A Center 4 Change | Psychologist | 5900 Us 60 W, Suite B, Ashland, KY 41101 | 2016-04-01 |
| 1013301159 | Precision Analysis Lab, LLC | Clinical Medical Laboratory | 101 17th Street, Ashland, KY 41101 | 2015-03-26 |
| 1639518574 | Steven Wayne Ledford Jr. | Dentist | 2301 Lexington Ave Ste 120, Ashland, KY 41101 | 2013-06-24 |
| 1528405875 | Brittani Kay Dingess | Pediatrics | 100 Ashland Dr, Ste 102, Ashland, KY 41101 | 2013-05-28 |
| 1770813487 | Paula Jean Hogsten | Clinical Nurse Specialist | 432 - 16th Street, Suite B- Tri State Nephrology, Ashland, KY 41101 | 2009-12-31 |
| Find all providers in zip 41101 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821435074 | Robert Louis Skaggs II | Dermatology | 1818 Wallace Court, Suite 301, Bowling Green, KY 42103 | 2013-05-29 |
| 1326203142 | Dermatology of Southern Kentucky Pllc | Dermatology | 85 Tower Cir, Somerset, KY 42503-3476 | 2008-07-21 |
| 1871593996 | Samuel J Pruden II | Dermatology | 989 Governors Ln Ste 220, Lexington, KY 40513-1175 | 2005-07-29 |
| 1457355174 | John L Buker | Dermatology | 3475 Richmond Rd, Ste 200, Lexington, KY 40509-2500 | 2005-06-10 |
| 1902302987 | Kentucky Skin Cancer Center Pllc | Dermatology | 1818 Wallace Court, Suite 301, Bowling Green, KY 42103 | 2018-03-30 |
| 1477922672 | Forefront Dermatology, S.c. | Dermatology | 2333 Ring Rd, Elizabethtown, KY 42701 | 2015-09-17 |
| 1861897217 | Forefront Dermatology, S.c. | Dermatology | 501 S 2nd St, Louisville, KY 40202 | 2014-10-28 |
| 1003133901 | Joseph Allen Blackmon | Dermatology | 2424 Harrodsburg Rd Ste 200, Lexington, KY 40503 | 2010-05-01 |
| 1609924018 | Buker Office Based Surgery, Pllc | Dermatology | 3475 Richmond Rd, Suite 200, Lexington, KY 40509-2500 | 2007-01-08 |
| 1932132768 | Dermatology and Skin Cancer Specialists, Psc | Dermatology | 2200 E Parrish Ave, Bldg E Suite 205, Owensboro, KY 42303-1449 | 2006-07-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.