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Brownsboro Dermatology PLLC

Dermatology in Louisville, KY. Organization (NPI-2).

NPI number1508911256
StatusActive
Last updated in NPPESSep 16, 2020

Details

NPI
1508911256
Entity type
Organization (NPI-2)
Legal business name
Brownsboro Dermatology PLLC
Organization subpart
No
Enumeration date
Jan 24, 2007
Certification date
Sep 16, 2020
Last updated
Sep 16, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X Dermatology26744KYYes

Practice location

4938 Brownsboro Rd
Suite 206
Louisville, KY 40222-6374

Phone 502-339-2922 · Fax 502-339-2912

Mailing address

4938 Brownsboro Rd
Suite 206
Louisville, KY 40222-6374

Phone 502-339-2922 · Fax 502-339-2912

Authorized official

Karen J Mosgrove
Office Manager
5023392922

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