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SKINMD, PLLC

Company Details

Name: SKINMD, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 13 Mar 2014 (11 years ago)
Organization Date: 13 Mar 2014 (11 years ago)
Last Annual Report: 26 Apr 2018 (7 years ago)
Managed By: Members
Organization Number: 0881936
ZIP code: 40513
City: Lexington
Primary County: Fayette County
Principal Office: 989 GOVERNORS LANE, STE 220, LEXINGTON, KY 40513
Place of Formation: KENTUCKY

Member

Name Role
Samuel Pruden Member
Sarah Smith Member

Registered Agent

Name Role
SAM PRUDEN, M.D. Registered Agent

Organizer

Name Role
SAM PRUDEN, M.D. Organizer

National Provider Identifier

NPI Number:
1629497714

Authorized Person:

Name:
SAMUEL PRUDEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
No
Selected Taxonomy:
207ND0101X - MOHS-Micrographic Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
5136724468
Fax:
5136723323

Filings

Name File Date
Administrative Dissolution 2019-10-16
Annual Report 2018-04-26
Registered Agent name/address change 2017-05-11
Annual Report 2017-05-11
Principal Office Address Change 2016-03-30

Sources: Kentucky Secretary of State