Provider Demographics
NPI:1346010469
Name:THE SKIN GROUP PLLC
Entity Type:Organization
Organization Name:THE SKIN GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WINNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-583-6647
Mailing Address - Street 1:2307 RIVER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-5000
Mailing Address - Country:US
Mailing Address - Phone:502-583-6647
Mailing Address - Fax:
Practice Address - Street 1:2307 RIVER RD STE 101
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-5000
Practice Address - Country:US
Practice Address - Phone:503-583-6647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty