| Dermatopathology Alliance Of Kentucky Pllc | |
|
839 S 2nd St Louisville KY 40203-2209 | |
| (502) 456-6217 | |
| (502) 456-4440 |
| Full Name | Dermatopathology Alliance Of Kentucky Pllc |
|---|---|
| Speciality | Pathology |
| Location | 839 S 2nd St, Louisville, Kentucky |
| Authorized Official Name and Position | Paul K Fearneyhough (PATHOLOGIST) |
| Authorized Official Contact | 5025835834 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dermatopathology Alliance Of Kentucky Pllc 1941 Bishop Ln Ste 1018 Louisville KY 40218-1928 Ph: (502) 456-6217 | Dermatopathology Alliance Of Kentucky Pllc 839 S 2nd St Louisville KY 40203-2209 Ph: (502) 456-6217 |
| NPI Number | 1548273733 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 02/19/2021 |
| Medicare PECOS PAC ID | 6507905940 |
|---|---|
| Medicare Enrollment ID | O20091125000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548273733 | NPI | - | NPPES |
| 151583XX | Other | PREFERRED CARE | |
| 5115678 | Other | KY | AETNA |
| 78469 | Other | KY | AETNA BETTER HEALTH |
| 2676260 | Medicaid | OH | |
| 6701094-000 | Medicaid | WV | |
| 690009345 | Other | RAILROAD MEDICARE | |
| BP87-0001 | Other | MD | BC/BS MD |
| 000000247638 | Other | KY | ANTHEM BLUE CROSS BS |
| 277243 | Other | VA | ANTHEM BCBS MC SUPP |
| 3103049 | Medicaid | NH | |
| 7100173900 | Medicaid | KY | |
| 000100269 | Medicaid | VA | |
| 4409994 | Medicaid | TN | |
| 50115665 | Other | KY | PASSPORT |
| 200364970A | Medicaid | IN | |
| 30004761050 | Other | KY | CARESOURCE |
| 611948801 | Other | KY | US DEPT LABOR BLACK LUNG |
| 93434 | Other | HEALTH PARTNERS | |
| 01895510 | Other | KY | ANTHEM MA |
| 611948800 | Other | KY | US DEPT LABOR DEEOIC |
| Provider Name | George B Sonnier |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1861495046 PECOS PAC ID: 0547211674 Enrollment ID: I20050207000611 |
| Provider Name | Paul K Fearneyhough |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1396858544 PECOS PAC ID: 3678612017 Enrollment ID: I20140808000526 |
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