Organization Name: | CUMBERLAND ORTHOPAEDICS AND SPORTS MEDICINE, PLLC |
NPI Number: | 1033167515 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEAN M. PAGE' (PRESIDENT OWNER) |
Mailing Address: | 160 London Mountain View Dr London |
State: | KY US |
Postal Code: | 407416601 |
Phone Number: | 6068640770 |
Fax Number: | 6068641461 |
NPI Enumeration Date: | 05/05/2006 |
NPI Last Update Date: | 04/13/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 00308 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |