Healthcare Provider Details

I. General information

NPI: 1306250790
Provider Name (Legal Business Name): STEVEN EDWIN EILERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 HARRODSBURG RD FL 2
LEXINGTON KY
40504-3516
US

IV. Provider business mailing address

1035 PRIMERA BLVD STE 1041
LAKE MARY FL
32746-2193
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-8082
  • Fax: 859-257-5901
Mailing address:
  • Phone: 407-992-0660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME140828
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MA10367100
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number59157
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number25MA10367100
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberME140828
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberME140828
License Number StateFL
# 7
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number59157
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: