Provider Demographics
NPI:1811285117
Name:DERMATOLOGY ASSOCIATES OF PIKEVILLE, PLLC
Entity type:Organization
Organization Name:DERMATOLOGY ASSOCIATES OF PIKEVILLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-432-5532
Mailing Address - Street 1:PO BOX 2500
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-2500
Mailing Address - Country:US
Mailing Address - Phone:606-432-5532
Mailing Address - Fax:606-432-9951
Practice Address - Street 1:1098 S MAYO TRL STE 211
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1574
Practice Address - Country:US
Practice Address - Phone:606-432-5532
Practice Address - Fax:606-432-9951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19685207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty