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BLUEGRASS DERMATOLOGY, PLLC
NPI 1881740884
Dermatology in Paducah, KY

Active since January 25, 2007
4616 VILLAGE SQUARE DRIVE, PADUCAH, KY 42001(270) 443-7546(270) 443-4002 Get Directions Write a Review

NPPES record last updated: April 1, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bluegrass Dermatology, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUEGRASS DERMATOLOGY, PLLC (NPI 1881740884) is a healthcare organization registered as a dermatology in Paducah, Kentucky and active in the NPI registry since January 2007. The organization lists Douglas M Wilson, Owner, as its authorized official.

NPPES Registry Identity

NPI1881740884
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameBLUEGRASS DERMATOLOGY, PLLC
Location Address4616 VILLAGE SQUARE DRIVEPaducah, KY 42001-7501
Mailing Address4616 Village Square DrivePaducah, KY 42001-7501 · (270) 443-7546 · Fax (270) 443-4002
Phone(270) 443-7546
Fax(270) 443-4002
Organization SubpartNo
Authorized OfficialDouglas M WilsonOwner · (270) 443-7546
Enumeration DateJanuary 25, 2007
Last NPPES UpdateApril 1, 2011
✔ NPI 1881740884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in KY · 36202
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
4616 VILLAGE SQUARE DRIVE, Paducah, KY 42001
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Other Identifiers 1

Medicare PIN9641KY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bluegrass Dermatology, PLLC's NPI number?

The NPI number for Bluegrass Dermatology, PLLC is 1881740884. It was assigned to this organization in the NPPES registry on January 25, 2007.

Where is Bluegrass Dermatology, PLLC located?

Bluegrass Dermatology, PLLC is located at 4616 Village Square Drive, Paducah, KY 42001. The listed phone number is (270) 443-7546.

What is Bluegrass Dermatology, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

When was this NPI record last updated?

The NPPES record for Bluegrass Dermatology, PLLC was last updated on April 1, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.