Provider Demographics
NPI:1992969604
Name:CUNDIFF, WILLIAM BENJAMIN (DO)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BENJAMIN
Last Name:CUNDIFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2119
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42702-2119
Mailing Address - Country:US
Mailing Address - Phone:270-706-5787
Mailing Address - Fax:270-706-5788
Practice Address - Street 1:110 LAYMAN LN
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2523
Practice Address - Country:US
Practice Address - Phone:270-706-5787
Practice Address - Fax:270-706-5788
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP853207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease