University Dermatopathology Consultants PSC

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

KY32113 Issued in KY

Legal business name

UNIVERSITY DERMATOPATHOLOGY CONSULTANTS PSC

Practice address

310 E Broadway
Suite 3a
Louisville, KY 40202-1745

Phone

(502) 569-7711

Fax

(502) 587-8119

NPI assigned

Mar 13, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Janine C Malone, M.D.

Title

President

Phone

(502) 569-7711

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262908800000",
    "number": "1245401645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E BROADWAY",
            "address_2": "SUITE 3A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021745",
            "telephone_number": "502-569-7711",
            "fax_number": "502-587-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E BROADWAY",
            "address_2": "SUITE 3A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021745",
            "telephone_number": "502-569-7711",
            "fax_number": "502-587-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY DERMATOPATHOLOGY CONSULTANTS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2010-01-08",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "JANINE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-569-7711",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Dermatopathology",
            "state": "KY",
            "license": "KY32113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100062460",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "3539028000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DP2238",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200919370A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50020526",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatopathology (Pathology) Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Dermatopathology (Pathology) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.