OrganizationActive
Commonwealth Community Care Centers, LLC
NPI 1568094670 · Procedural Dermatology Physician · Prestonsburg, KY
Provider details
- NPI number
- 1568094670
- Entity type
- Organization
- Primary specialty
- Procedural Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Yvette Wisener, Billing(256) 258-9603
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Obstetrics & Gynecology Physician207V00000X
Allopathic & Osteopathic Physicians
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
154 N Lake Dr
Prestonsburg, KY 41653-1270
Phone: (606) 506-5093
Fax: (606) 506-5039
Approximate (ZIP-level) locationGet directions
Mailing address
156 North Lake Drive
Prestonburg, KY 41653
Additional practice locations (3)
- 601 N Shore Dr Ste 203Jeffersonville, IN 47130-3145Phone: (606) 263-4283Fax: (606) 263-4285
- 4010 Dupont Cir Ste 370Louisville, KY 40207-4881Phone: (606) 263-4283Fax: (606) 263-4285
- 2008 Merchant DrRichmond, KY 40475-8188Phone: (606) 263-4283Fax: (606) 263-4285
Registry dates
- Enumerated
- 2020-02-06
- Last updated
- 2022-09-02
- Certified
- 2022-09-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.