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Contact Information

BARDSTOWN DERMATOLOGY PSC
114 MANOR DR
BARDSTOWN, KY40004-3230
 Phone: 502-349-9999
 Fax: 502-349-9499
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Medical

363AM0700X 97 Physician Assistant
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for BARDSTOWN DERMATOLOGY PSC · (Female)

NPI # 1932260783
Status Active
Credentials
Entity Individual
Enumeration date 12/13/2006
Last updated 01/17/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • KY Medicaid 65934416
  • KY Other 9809 MEDICARE
  • KY Other 1135703 PASSPORT
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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