East Louisville Dermatology, PSC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

24086 Issued in KY

Legal business name

EAST LOUISVILLE DERMATOLOGY, PSC

Practice address

4912 US Highway 42
Suite 208
Louisville, KY 40222-6349

Phone

(502) 426-9565

Fax

(502) 425-3240

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Terrie S Williams, M.D.

Title

President

Phone

(502) 426-9565

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Neil Hubert, MD

  • Dermatology Physician
  • Louisville, KY
  • NPI 1437141462
  NPD (past)
• Laura R Klein, MD

  • Dermatology Physician
  • Louisville, KY
  • NPI 1437140621
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255468872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 US HIGHWAY 42",
            "address_2": "SUITE 208",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402226349",
            "telephone_number": "502-426-9565",
            "fax_number": "502-425-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4912 US HIGHWAY 42",
            "address_2": "SUITE 208",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402226349",
            "telephone_number": "502-426-9565",
            "fax_number": "502-425-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LOUISVILLE DERMATOLOGY, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TERRIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-426-9565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "KY",
            "license": "24086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• East Louisville Counseling, PLLC
• East Louisville Dental Group
• East Louisville Inpatient Medicine, PLLC
• East Louisville Interventional Pain Specialists PLLC
• East Louisville Interventional Pain Specialists, PLLC
• East Louisville Neurology, PSC
• East Louisville Oral Surgery and Dental Implants PLC

• Dermatology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Dermatology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.