Pruden, Samuel J

Pruden, Samuel J is an individual health care provider with primary practice located at 989 Governors Ln Ste 260 , Lexington KY 40513-1175. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Pruden, Samuel J can be contacted via phone (859) 296-7546.

Contact Information

Primary practice address
989 Governors Ln Ste 260 Lexington KY 40513-1175
Phone: (859) 296-7546
Fax: (859) 721-0829
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X 34192 Kentucky
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 34192 Kentucky
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 34192 Kentucky
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 34192 Kentucky

Profile Details

NPI number 1871593996
LBN Legal business name Pruden, Samuel J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Dec 15th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871593996 NPPES
Kentucky Other 000000823142 ANTHEM BCBS
Kentucky MEDICAID 64051196 ANTHEM BCBS

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