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General NPI Number Information
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NPI Number | 1063617173
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Entity Type | Organization
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Legal Business Name | VELLAIAPPAN SOMASUNDARAM M.D. PLLC
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 04/29/2010
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Provider Practice Location Address
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Address Line | 306 HOSPITAL DR STE 202C
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City | SOUTH WILLIAMSON
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State | KY
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Zip | 41503-4096
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Country | US
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Telephone | 606-237-5800
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Fax | 606-237-5858
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Provider Business Mailing Address
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Address Line | 306 HOSPITAL DR STE 202C
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City | SOUTH WILLIAMSON
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State | KY
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Zip | 41503-4096
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Country | US
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Telephone | 606-237-5800
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Fax | 606-237-5858
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Authorized Official
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Title or Position | OWNER
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Name | DR. VELLAIAPPAN SOMASUNDARAM
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Credential | M.D.
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Telephone | 606-237-5800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35436
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3567P
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 35436
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License Number State | KY
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