Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Samuel Addison Gulley, PA-S

Individual provider Physician Assistant · NPI 1114718905

Samuel Addison Gulley, PA-S is a Physician Assistant in Fort Campbell, Kentucky. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
3

Practice location Address checks out

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone: (270) 956-0336
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Physician Assistant Taxonomy 363A00000X
Military Health Care Provider Taxonomy 171000000X

Record details

NPI number1114718905
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-S
Sole proprietorNo
NPI enumeratedMay 13, 2025
Last updated in NPPESMay 13, 2025
Certification dateMay 13, 2025

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