Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bluegrass Dermatology, PLLC

Organization Dermatology Physician · NPI 1881740884

Bluegrass Dermatology, PLLC is a Dermatology Physician in Paducah, Kentucky. Licensed in Kentucky. Registered with an NPI since 2007.

Licensed in
KY
In the registry since
2007
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4616 Village Square Dr
Paducah, KY 42001-7501
Phone: (270) 443-7546
Fax: (270) 443-4002
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 36202 (KY)

Record details

NPI number1881740884
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Douglas Wilson — Owner · (270) 443-7546
NPI enumeratedJanuary 25, 2007
Last updated in NPPESApril 1, 2011
Mailing address4616 Village Square Drive, Paducah, KY 42001-7501

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