Organization · Type 2 NPI

Regional Dermatology PLLC

MOHS-Micrographic Surgery Physician · Lexington, KY

NPI number 1255851200 Active

Practice location

989 Governors Ln Ste 220
Lexington, KY 40513-1175

Fax (859) 721-0829

Specialties and licenses

Taxonomy	Code	License
MOHS-Micrographic Surgery Physician Primary	207ND0101X	34192 (KY)
Dermatopathology Physician	207ND0900X	34192 (KY)
Otolaryngology Physician	207Y00000X	34192 (KY)
Plastic Surgery Physician	208200000X	34192 (KY)
Medical Physician Assistant	363AM0700X	None listed

MOHS-Micrographic Surgery Physician: 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…

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NPI record

NPI: 1255851200
Entity type: Organization (Type 2)
Issued: Jun 21, 2017
Last updated: Jul 21, 2022
Status: Active

Other names

<unavail>
Skin MD · doing business as
Skin MD · doing business as
Skinmd · doing business as

Authorized official

Dr. Samuel J Pruden, MD
President
(859) 296-7546

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1255851200

Regional Dermatology PLLC's National Provider Identifier is 1255851200, issued on Jun 21, 2017. The primary taxonomy on file is MOHS-Micrographic Surgery Physician (207ND0101X), and the practice location is in Lexington, KY. The record was last updated on Jul 21, 2022.