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NPI Code Detail

MEDICARE: LEXINGTON DERMATOLOGY & LASER CENTER PSC

MEDICARE: LEXINGTON DERMATOLOGY & LASER CENTER PSC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2207N00000XDermatology Physician

General Provider Information

NPI Number : 1932486651
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEXINGTON DERMATOLOGY & LASER CENTER PSC
Provider Business Mailing Address
First Line : 4071 TATES CREEK CENTRE DR STE 202
Second Line :
City : LEXINGTON
State : KY
Zip : 40517-3094
Country : US
Telephone Number : 859-226-0206
Fax Number : 859-745-0836
Provider Business Practice Location Address
First Line : 4071 TATES CREEK CENTRE DR STE 202
Second Line :
City : LEXINGTON
State : KY
Zip : 40517-3094
Country : US
Telephone Number : 859-226-0206
Fax Number : 859-226-0207
Authorized Official
Title or Position : OWNER
Name : DEBORAH K PHILLIPS
Credential : MD
Telephone Number : 903-736-3337
Provider Enumeration Date : 11/09/2011
Last Update Date : 01/09/2019

Similar Medicare Providers

1043215536 — MRS. GRETCHEN B. CLIBURN PA-C
Practice Location Address:
4071 TATES CREEK CENTRE DR STE 202
LEXINGTON, KY
40517-3094
Practice Phone: 859-226-0206
Practice Fax:
1306848841 — MRS. KIRSTEN M ADAIR PA-C
Practice Location Address:
4071 TATES CREEK CENTRE DR STE 202
LEXINGTON, KY
40517-3094
Practice Phone: 859-226-0206
Practice Fax:
1124002811 — DEBORAH K PHILLIPS MD
Practice Location Address:
4071 TATES CREEK CENTRE DR STE 202
LEXINGTON, KY
40517-3094
Practice Phone: 859-226-0206
Practice Fax:
1669533295 — JULENA D ADAMS PA-C
Practice Location Address:
4071 TATES CREEK CENTRE DR STE 202
LEXINGTON, KY
40517-3094
Practice Phone: 859-226-0206
Practice Fax: 859-226-0207
1881036259 — SARAH MILLER DOUGHERTY PA-C
Practice Location Address:
4071 TATES CREEK CENTRE DR STE 202
LEXINGTON, KY
40517-3094
Practice Phone: 859-226-0206
Practice Fax: 859-226-0207
1225530660 — TATES CREEK DENTAL, PSC
Practice Location Address:
4071 TATES CREEK CENTRE DR STE 210
LEXINGTON, KY
40517-3094
Practice Phone: 859-273-3139
Practice Fax:

Directions to “LEXINGTON DERMATOLOGY & LASER CENTER PSC ” Practice Location

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