PIKEVILLE DERMATOLOGY & COSMETIC CENTER PSC NPI 1235343419

NPI Information

  • NPI: 1235343419
  • Provider Name: PIKEVILLE DERMATOLOGY & COSMETIC CENTER, PSC
  • Classification: Dermatology - 207NS0135X
  • Specialization: Procedural Dermatology
  • Entity Type: Organization
  • CLIA Number: 18D1062949
  • Address: 108 N AUXIER AVE
    PIKEVILLE, KY
    ZIP 41501
  • Phone: (606) 432-9106

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NPI Details

PIKEVILLE DERMATOLOGY & COSMETIC CENTER, PSC is a procedural dermatology dermatology in Pikeville, KY. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). PIKEVILLE DERMATOLOGY & COSMETIC CENTER, PSC NPI is 1235343419. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

108 N AUXIER AVE
PIKEVILLE, KY
ZIP 41501-045
Phone: (606) 432-9106
Fax: (606) 432-0967

The provider's authorized official is Timothy R Lavender .
The authorized official title is Owner & Physician and has the following contact phone number (606) 432-9106.

The CLIA number assigned to this NPI record is 18D1062949 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/9/2007 and was last updated on 6/11/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207NS0135XDermatologyProcedural Dermatology02627KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15900011000MEDICAIDWEST VIRGINIA
264005812MEDICAIDKENTUCKY
3010250030MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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