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

Central Kentucky Dermatology PLLC

Organization Dermatology Physician · NPI 1124741780

Central Kentucky Dermatology PLLC is a Dermatology Physician in Nicholasville, Kentucky. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
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

249 E Brannon Rd
Nicholasville, KY 40356-8059
Phone: (859) 354-5455
Fax: (859) 203-8833
Show map & directions

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

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1124741780
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Todd Clark — Medical Director · (859) 608-9917
NPI enumeratedSeptember 20, 2022
Last updated in NPPESJuly 10, 2025
Certification dateJuly 10, 2025
Mailing address249 E Brannon Rd, Nicholasville, KY 40356-8059

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