| NPI | 1669539789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN THOMAS LOGSDON Dermatologist Owner 502-363-1841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2013-12-02 |