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Organization
LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC
Active
Organization
LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC
Active
Other names
Cardiothoracic Surgical Associates of Lake Cumberland
Organization subpart
No
Provider details
NPI number
Authorized official
SARA MILLER (DIRECTOR)
(615) 920-7514
Entity
Organization
Contact information
Practice address
120 TRADEPARK DR, SUITE B, SOMERSET, KY 42503-3454
(606) 451-0300
(606) 451-0595
Mailing address
120 TRADEPARK DR, SUITE B, SOMERSET, KY 42503-3454
(606) 451-0300
(606) 451-0595
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
NULL
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
02/13/2009
Last updated
09/27/2017
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