DR. MARK J ZALLA (NPI# 1356460018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356460018 |
| Entity Type | Individual |
| Full Name | DR. MARK J ZALLA |
| Credential | M.D. |
| Practice Address |
7766 Ewing Blvd Ste 100 Florence KY 41042-7538 |
| Practice Telephone | 8592831033 |
| Practice Fax Number | 8592831066 |
| Mailing Telephone | 8592831033 |
| Mailing Fax Number | 8592831066 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2009-12-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 35119 | KY | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
35119 | KY | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
K35119 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | ANTHEM ID | 000000223589 | 01 |
| AETNA ID | 2815155 | 01 | |
| UNITED HEALTHCARE ID | 03-20159 | 01 |
| Street Address |
7766 EWING BLVD STE 100 |
| City | FLORENCE |
| State | KY |
| Zip Code | 41042-7538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255324927 | Barbara Lehman | Registered Nurse | 7766 Ewing Blvd, Su. L, Florence, KY 41042-7537 | 2005-08-26 |
| 1902227366 | Mae Dinn | Physician Assistant | 7766 Ewing Blvd, Ste 100, Florence, KY 41042-7537 | 2014-01-02 |
| 1598003832 | Pinnacle One Dental Group | Clinic/Center | 7766 Ewing Blvd, Floor 3, Florence, KY 41042-7537 | 2013-01-22 |
| 1376832188 | Sabra Marie Abner | Dermatology | 7766 Ewing Blvd, Suite 100, Florence, KY 41042-7538 | 2011-04-01 |
| 1669611653 | Ria Asistin Santos | Family Medicine | 7766 Ewing Blvd, Florence, KY 41042-7537 | 2009-02-13 |
| 1972742963 | Oliver James Benes | Family Medicine | 7766 Ewing Blvd, Florence, KY 41042 | 2009-02-13 |
| 1013156108 | Elizabeth N Velazquez | Family Medicine | 7766 Ewing Blvd, Suite L, Florence, KY 41042-7537 | 2009-02-12 |
| 1518137843 | Kristin Dietz Kennedy | Nurse Practitioner | 7766 Ewing Blvd, Ste 100, Florence, KY 41042-7537 | 2008-03-03 |
| 1609995091 | James A Zalla | Dermatology | 7766 Ewing Blvd, Ste 100, Florence, KY 41042-7538 | 2007-03-28 |
| 1073632733 | Susan J Bushelman | Dermatology | 7766 Ewing Blvd, Ste 100, Florence, KY 41042-7538 | 2007-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710596010 | Stacey Deann Cruse | Counselor | 71 Cavalier Blvd #303, Florance, KY 41042 | 2020-07-23 |
| 1760044705 | Loretta Macaluso | Speech-Language Pathologist | 1515 Cavalry Drive, Suite 202, Florence, KY 41042 | 2019-06-29 |
| 1659879559 | Christina Shrader | Counselor | 71 Cavalier Blvd Ste 113, Florence, KY 41042 | 2018-01-25 |
| 1891200267 | Rachel Knuehl | Case Manager/Care Coordinator | 8140 Dream Street, Florence, KY 41042 | 2017-12-07 |
| 1427560697 | Marie Nicole Sartori | Nurse Practitioner | 7766 Ewing Blvd Ste 100, Florence, KY 41042 | 2017-10-27 |
| 1669903910 | Northern Kentucky Smiles | Dentist | 1481 Cavalry Drive, Suite 100, Florence, KY 41042 | 2017-03-27 |
| 1306394937 | Mary Austin | Nurse Practitioner | 7766 Ewing Boulevard, Florence, KY 41042 | 2016-09-12 |
| 1598211633 | Samantha Growe | Counselor | 7000 Houston Rd Ste 16, Florence, KY 41042 | 2016-08-29 |
| 1982079299 | Jessica Adelyn Goodridge | Doula | 2224 Forest Lawn Dr., Florence, KY 41042 | 2015-12-11 |
| 1083083414 | Victoria Maruca Havron | Psychologist | 6900 Houston Rd Ste 11, Florence, KY 41042 | 2015-09-16 |
| Find all providers in zip 41042 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710088216 | Northampton Dermatology Associates, P.C. | Dermatology | 190 Nonotuck Street, Suite 107, Florence, MA 01062 | 2006-09-26 |
| 1659388726 | David A Shearer | Dermatology | 10060 Demia Way, The Dermatology Center, Florence, KY 41042 | 2006-08-02 |
| 1932149549 | Heather F Mccown | Dermatology | 1929a Mountain Laurel Ct, Florence, SC 29505-6053 | 2006-06-08 |
| 1508837394 | Brian Christopher Thomas | Dermatology | 2471 Helton Dr, Florence, AL 35630-1067 | 2006-01-30 |
| 1184065690 | Natalie Leticia Hone Romero | Dermatology | 7370 Turfway Rd, Florence, KY 41042 | 2013-07-12 |
| 1538455753 | Noah Hodsdon Kahn | Dermatology | 1929 Mountain Laurel Ct, Florence, SC 29505-6053 | 2011-06-27 |
| 1295029361 | Kristen Ahern | Dermatology | 7370 Turfway Rd, Florence, KY 41042 | 2011-06-06 |
| 1376832188 | Sabra Marie Abner | Dermatology | 7766 Ewing Blvd, Suite 100, Florence, KY 41042-7538 | 2011-04-01 |
| 1104017011 | The Dermatology Center Psc | Dermatology | 10060 Demia Way, Florence, KY 41042 | 2007-08-06 |
| 1609995091 | James A Zalla | Dermatology | 7766 Ewing Blvd, Ste 100, Florence, KY 41042-7538 | 2007-03-28 |
| Find all providers in FLORENCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.