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Organization
CUMBERLAND FOOT AND ANKLE CENTERS
Active
Organization
CUMBERLAND FOOT AND ANKLE CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN E MOORE DPM (PRESIDENT/PODIATRIST)
(606) 679-2773
Entity
Organization
Contact information
Practice address
1850 WESTEN STREET, BOWLING GREEN, KY 42104
(270) 846-3338
(270) 846-3318
Mailing address
117 TRADEPARK DR STE B, SOMERSET, KY 42503-3428
(606) 679-2773
(606) 679-4626
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
213ES0131X
Foot Surgery Podiatrist
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100207030
—
KY
05
—
7100234690
—
KY
Enumeration date
01/25/2018
Last updated
01/25/2018
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