Individual
SAMUEL ADAM CUNDIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1350 BULL LEA RD, LEXINGTON, KY 40511-1247
(859) 246-8000
(859) 246-8032
Mailing address
2781 RUBY RIVER DR APT 1103, LEXINGTON, KY 40511-6524
(859) 475-6773
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3445
KY
363AM0700X
Medical Physician Assistant
PA3445
KY
363AS0400X
Surgical Physician Assistant
PA3445
KY
Other
Enumeration date
01/16/2024
Last updated
01/10/2025
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