# SOUTHERN KY MEDICAL ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508196262
- **Authorized official:** ANGELA CUNDIFF / ROY MSN , CANP (CANP)
- **Authorized official phone:** (270) 866-4357

## Contact information

- **Practice address:** 72 JOE T PETTY DR, RUSSELL SPRINGS, KY 42718
- **Practice address phone:** (270) 866-4357
- **Practice address fax:** (270) 858-4957
- **Mailing address:** 72 JOE T PETTY DR, RUSSELL SPRINGS, KY 42718
- **Mailing address phone:** (270) 866-4357
- **Mailing address fax:** (270) 858-4957

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 364SA2200X | Adult Health Clinical Nurse Specialist | 2287P | KY | Yes |

## Other

- **Enumeration date:** 12/31/2009
- **Last updated:** 12/31/2009