Provider Demographics
NPI:1619648326
Name:PINNACLE DERMATOLOGY, SC
Entity Type:Organization
Organization Name:PINNACLE DERMATOLOGY, SC
Other - Org Name:PINNACLE DERMATOLOGY, CRAWFORDSVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:LAPINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-744-8554
Mailing Address - Street 1:5141 VIRGINIA WAY STE 350
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1601 LAFAYETTE RD STE 100
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-1032
Practice Address - Country:US
Practice Address - Phone:765-362-1221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINNACLE DERMATOLOGY, SC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-22
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site