| NPI | 1326203142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN L BAKER Physician/Owner 606-772-3376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KY 39921) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: KY 39921) |
| 363L00000X Nurse Practitioner (Licence: KY 5583P) | |
| 363A00000X Physician Assistant (Licence: KY PA1591) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2012-03-28 |