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DERMATOLOGY OF SOUTHERN KENTUCKY, PLLC

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Company Details

Name: DERMATOLOGY OF SOUTHERN KENTUCKY, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 22 Oct 2007 (18 years ago)
Organization Date: 22 Oct 2007 (18 years ago)
Last Annual Report: 25 Feb 2025 (3 months ago)
Managed By: Members
Organization Number: 0676403
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 42564
City: West Somerset
Primary County: Pulaski County
Principal Office: P.O. BOX 3535, WEST SOMERSET, KY 42564
Place of Formation: KENTUCKY

Member

Name Role
Brian L Baker Member

Organizer

Name Role
BRIAN L. BAKER Organizer

Registered Agent

Name Role
BRIAN L. BAKER Registered Agent

National Provider Identifier

NPI Number:
1326203142

Authorized Person:

Name:
DR. BRIAN L BAKER
Role:
PHYSICIAN/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207ND0101X - MOHS-Micrographic Surgery Physician
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Fax:
6066770335

Form 5500 Series

Employer Identification Number (EIN):
743252760
Plan Year:
2023
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
4
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
BAKER DERMATOLOGY Active 2025-11-03
DERM SOUTH Inactive 2022-10-22

Filings

Name File Date
Annual Report 2025-02-25
Annual Report 2024-05-31
Annual Report 2023-03-23
Annual Report 2022-07-12
Annual Report 2021-05-06

USAspending Awards / Financial Assistance

Date:
2020-04-30
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
83047.00
Total Face Value Of Loan:
83047.00

Paycheck Protection Program

Date Approved:
2020-04-30
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
83047
Current Approval Amount:
83047
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
83397.39

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Sources: Kentucky Secretary of State