Healthcare Provider Details

I. General information

NPI: 1659218402
Provider Name (Legal Business Name): EDWARD SYNDOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 US HIGHWAY 62 W
PRINCETON KY
42445-6106
US

IV. Provider business mailing address

PO BOX 614
HOPKINSVILLE KY
42241-0614
US

V. Phone/Fax

Practice location:
  • Phone: 270-365-2008
  • Fax:
Mailing address:
  • Phone: 270-886-2205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: