Individual
WILLIAM VANMETER SUDDUTH IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-7001
(859) 323-0295
Mailing address
900 S LIMESTONE CTW320, LEXINGTON, KY 40536-0200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA684
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
950025800
—
KY
01
—
970023737
RAILROAD MEDICARE
KY
Enumeration date
07/31/2006
Last updated
12/03/2020
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