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

Regional Dermatology PLLC

Organization MOHS-Micrographic Surgery Physician · NPI 1255851200

Regional Dermatology PLLC is an MOHS-Micrographic Surgery Physician in Lexington, Kentucky. Licensed in Kentucky. Registered with an NPI since 2017.

Licensed in
KY
In the registry since
2017
Specialties on file
5
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

989 Governors Ln Ste 220
Lexington, KY 40513-1175
Phone: (859) 296-7546
Fax: (859) 721-0829
Show map & directions

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

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence 34192 (KY)
Dermatopathology Physician Taxonomy 207ND0900X · Licence 34192 (KY)
Otolaryngology Physician Taxonomy 207Y00000X · Licence 34192 (KY)
Plastic Surgery Physician Taxonomy 208200000X · Licence 34192 (KY)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1255851200
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Samuel Pruden — President · (859) 296-7546
Other names Skin Md; Skin Md; Skinmd
NPI enumeratedJune 21, 2017
Last updated in NPPESJuly 21, 2022
Mailing address989 Governors Ln Ste 220, Lexington, KY 40513-1175

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