Individual
SAMUEL JACOB DEDDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
Mailing address
4842 DARTMOUTH DR, BURLINGTON, KY 41005-9132
(859) 803-7696
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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