Individual
KEVIN A CADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1001 SAINT JOSEPH LN, LONDON, KY 40741-8345
(606) 330-6000
Mailing address
1001 SAINT JOSEPH LN, LONDON, KY 40741-8345
(606) 224-9576
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1704
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA1704
PA LICENSE
KY
Enumeration date
03/15/2012
Last updated
06/30/2014
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