Healthcare Provider Details

I. General information

NPI: 1891745386
Provider Name (Legal Business Name): VELLAIAPPAN SOMASUNDARAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 HOSPITAL DRIVE SUITE 202C
SOUTH WILLIAMSON KY
41503
US

IV. Provider business mailing address

306 HOSPITAL DR STE 204
SOUTH WILLIAMSON KY
41503-4096
US

V. Phone/Fax

Practice location:
  • Phone: 606-237-5800
  • Fax: 606-237-5858
Mailing address:
  • Phone: 606-237-5800
  • Fax: 606-237-5858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35436
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberT9601
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35436
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: