Individual
ANDREW C RUTHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
250 MAIN ST, SUITE A, CADIZ, KY 42211-9153
(270) 522-3444
Mailing address
4208 VICTORIA WAY, LEXINGTON, KY 40515-4822
(270) 522-3444
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1945
KY
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1120392
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
—
01
—
PA1945
STATE LICENSE
KY
Enumeration date
08/07/2014
Last updated
11/12/2015
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