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NPI 1629497714 · MOHS-Micrographic Surgery Physician · Lexington, KY
Provider details
- NPI number
- 1629497714
- Entity type
- Organization
- Primary specialty
- MOHS-Micrographic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Samuel Pruden, President(859) 276-7546
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Dermatology Physician207N00000X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
989 Governors Ln
Suite 220
Lexington, KY 40513-1173
Phone: (859) 296-7546
Fax: (513) 672-3323
Street-level locationGet directions
Mailing address
200 Northland Blvd
Cincinnati, OH 45246-3604
Registry dates
- Enumerated
- 2014-04-16
- Last updated
- 2014-07-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.