| Organization Name: | CUMBERLAND FOOT AND ANKLE CENTER |
| NPI Number: | 1508172701 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JONATHAN E MOORE (OWNER/PODIATRIST) |
| Mailing Address: | 92 Joe T Petty Dr Russell Springs |
| State: | KY US |
| Postal Code: | 426428544 |
| Phone Number: | 2708667303 |
| Fax Number: | 2708667306 |
| NPI Enumeration Date: | 08/25/2010 |
| NPI Last Update Date: | 08/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |