Individual
MR. JOSEPH S CADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1001 SAINT JOSEPH LN, LONDON, KY 40741-8345
(606) 330-6000
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7818
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA974
KY
363AM0700X
Medical Physician Assistant
1449
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1449
PA LICENCE
TN
05
—
7100313470
—
KY
01
—
PA974
LICENSE
KY
Enumeration date
11/16/2006
Last updated
05/03/2019
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