Individual
DR. SAMUEL CLINTON WALLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4001 KRESGE WAY STE 200, LOUISVILLE, KY 40207-4640
(502) 895-1995
(502) 928-3972
Mailing address
800 ROSE ST # C-246, LEXINGTON, KY 40536-0293
(859) 323-6162
(859) 257-8934
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
56880
KY
390200000X
Student in an Organized Health Care Education/Training Program
56880
KY
Other
Enumeration date
03/22/2017
Last updated
05/22/2023
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