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General NPI Number Information
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NPI Number | 1184670325
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Entity Type | Individual
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Provider Name | LYDIA C. SAMPLES M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 601 VERSAILLES RD
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City | FRANKFORT
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State | KY
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Zip | 40601-3857
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Country | US
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Telephone | 502-695-3946
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Fax |
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Provider Business Mailing Address
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Address Line | 4350 HAMILTON CLEVES RD
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City | CLEVES
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State | OH
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Zip | 45002-9343
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Country | US
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Telephone | 513-215-6400
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Fax | 513-215-6401
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35069396
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 37175
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License Number State | KY
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