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General NPI Number Information
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NPI Number | 1093696734
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Entity Type | Organization
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Legal Business Name | VALLEY SKIN SPECIALISTS KENTUCKY PL LC
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 2424 SIR BARTON WAY STE 125
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City | LEXINGTON
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State | KY
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Zip | 40509-2522
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Country | US
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Telephone | 859-203-6990
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Fax | 859-203-6991
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Provider Business Mailing Address
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Address Line | 2424 SIR BARTON WAY STE 123
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City | LEXINGTON
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State | KY
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Zip | 40509-2521
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Country | US
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Telephone | 859-203-6990
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Fax | 859-203-6991
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Authorized Official
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Title or Position | OWNER
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Name | CHAD JOHNSTON
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Credential | DO
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Telephone | 540-951-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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