KENTUCKY SKIN CANCER CENTER PLLC (NPI# 1902302987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902302987 |
| Entity Type | Organization |
| Organization Name | KENTUCKY SKIN CANCER CENTER PLLC |
| Practice Address |
1818 Wallace Court Suite 301 Bowling Green KY 42103 |
| Practice Telephone | 2709073030 |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2018-04-17 |
| Authorized Official Name | ROBERT SKAGGS II (OWNER) |
| Authorized Official Telephone | 2709073030 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
1818 WALLACE COURT SUITE 301 |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821435074 | Robert Louis Skaggs II | Dermatology | 1818 Wallace Court, Suite 301, Bowling Green, KY 42103 | 2013-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679127781 | Kw Consulting, LLC | Counselor | 1054 Searcy Way, Suite E, Bowling Green, KY 42103 | 2019-07-26 |
| 1063999662 | Southern Kentucky Surgicenter, LLC | Clinic/Center | 484 Golden Autumn Way, Suite 100, Bowling Green, KY 42103 | 2018-07-26 |
| 1780170936 | Midsouth Psychological Services, LLC | Psychologist | 996 Wilkinson Trce Ste A8, Bowling Green, KY 42103 | 2018-07-10 |
| 1760976146 | Prorehab Inc | Clinic/Center | 1110 Wilkinson Trce Ste 101, Bowling Green, KY 42103 | 2018-06-19 |
| 1063927671 | James Toney | Counselor | 624 Eastwood St, Bowling Green, KY 42103 | 2017-12-05 |
| 1366979528 | Laura Elizabeth Compton | Optometrist | 335 New Towne Drive, Bowling Green, KY 42103 | 2017-05-18 |
| 1033562632 | Elizabette Raby | Massage Therapist | 427 Us-31 Bypass, Suite 203, Bowling Green, KY 42103 | 2016-07-19 |
| 1831572460 | Casey Edward Travelsted | Dentist | 940 Us 31 W Bypass, Bowling Green, KY 42103 | 2015-07-01 |
| 1770893257 | Michelle Howell | Health Educator | 261 Moats Lane, Bowling Green, KY 42103 | 2010-10-18 |
| 1952578593 | Steven Snodgrass | Surgery | 996 Wilkinson Trace, Suite B 3, Bowling Green, KY 42103 | 2008-05-13 |
| Find all providers in zip 42103 | ||||
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326203142 | Dermatology of Southern Kentucky Pllc | Dermatology | 85 Tower Cir, Somerset, KY 42503-3476 | 2008-07-21 |
| 1740315589 | Jack Foster Ditty Jr. | Dermatology | 100 Saint Christopher Dr, Ashland, KY 41101-7016 | 2007-02-22 |
| 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 |
| 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 |
| 1114969201 | Johnathon Curtis Edge | Dermatology | 2200 E Parrish Ave, Bldg E Suite 205, Owensboro, KY 42303-1449 | 2006-06-12 |
| Find all providers with the same taxonomy | ||||
| City | BOWLING GREEN |
| Zip Code | 42103 |
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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.