KENTUCKY DERMATOLOGY CLINIC, PLLC (NPI# 1770806424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770806424 |
| Entity Type | Organization |
| Organization Name | KENTUCKY DERMATOLOGY CLINIC, PLLC |
| Practice Address |
120 State Ave Glasgow KY 42141-1451 |
| Mailing Address |
5480 Wisconsin Ave #920 Chevy Chase MD 20815-3530 |
| Practice Telephone | 9173717230 |
| Practice Fax Number | 6364442042 |
| Mailing Telephone | 9173717230 |
| Mailing Fax Number | 6364442042 |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2012-06-26 |
| Authorized Official Name | CLEMENS ESCHE (CEO) |
| Authorized Official Telephone | 9173717230 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 43075 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100106910 | 05 |
| Street Address |
120 STATE AVE |
| City | GLASGOW |
| State | KY |
| Zip Code | 42141-1451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710505912 | Adriene Elizabeth Wilson | Nurse Practitioner | 310 N. L. Rogers Blvd., Glasgow, KY 42141 | 2020-07-14 |
| 1649896648 | Katrina Antonette Casanova Tinoco | Student in an Organized Health Care Education/Training Program | 1325 North Race St., University of Louisville/glasgow, Glasgow, KY 42141 | 2020-06-25 |
| 1245744630 | Town and Country Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 742a East Main Street, Glasgow, KY 42141 | 2017-11-22 |
| 1821413022 | Russell England | Nurse Practitioner | 370 Beaver Mound Circle, Glasgow, KY 42141 | 2014-02-25 |
| 1447507439 | Rehabcare | Skilled Nursing Facility | 109homewoodblvd, Glasgow, KY 42141 | 2012-08-08 |
| 1578847778 | Alexander Kwadwo Somuah | Pharmacist | 1001 W. Main St, Glasgow, KY 42141 | 2011-10-06 |
| 1518240522 | William David Wiley | Pharmacist | 1001 West Main St., Glasgow, KS 42141 | 2011-09-26 |
| 1003121732 | Teresa Katherine Essex | Speech-Language Pathologist | 341 Ginger Rd, Glasgow, KY 42141 | 2010-08-18 |
| 1396915468 | R David Fant Md Psc | Pediatrics | 1407 North Race St, Glasgow, KY 42141 | 2008-03-05 |
| 1003021957 | Eddy Joe Newberry II | Dentist | 400 S. Broadway, Glasgow, KY 42141 | 2007-05-14 |
| Find all providers in zip 42141 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225423742 | Virginia Nell Kartha | Dermatology | 3810 Springhurst Blvd Ste 20, Louisville, KY 40241-6162 | 2015-04-01 |
| 1053757641 | Chase Landon Wilson | Dermatology | 304 Boston Sq, Georgetown, KY 40324-9786 | 2013-05-22 |
| 1316206584 | Carol B Thompson | Dermatology | 3475 Richmond Rd Ste 200, Lexington, KY 40509-2500 | 2012-05-09 |
| 1851665038 | Shannon England | Dermatology | 13802 Lake Point Cir, #102, Louisville, KY 40223-4219 | 2012-03-06 |
| 1659640878 | George J. Gataky, P.s.c. | Dermatology | 3 Audubon Plaza Dr Ste 630, Louisville, KY 40217-1362 | 2011-12-16 |
| 1811285117 | Dermatology Associates of Pikeville, Pllc | Dermatology | 1098 S Mayo Trl Ste 211, Pikeville, KY 41501-1574 | 2011-07-20 |
| 1629243860 | J David Outland, M.d. | Dermatology | 300 S 8th St Ste 405e, Murray, KY 42071-2444 | 2008-04-29 |
| 1659542058 | Ky Dermatology & Skin Cancer | Dermatology | 1750 Highway 192 W, London, KY 40741-2639 | 2008-03-13 |
| 1609047083 | Bowling Green Dermatology & Skin Cancer Specialists Pllc | Dermatology | 1106 Fairway Street, Bowling Green, KY 42103 | 2008-03-13 |
| 1902080559 | John David Cowan | Dermatology | 1106 Fairway St, Bowling Green, KY 42103-2418 | 2007-12-18 |
| 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.