# LAKE CUMBERLAND PHYSICIAN PRACTICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake Cumberland Family Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437440054
- **Authorized official:** KATHY TEAGUE (SECRETARY / AUTHORIZED OFFICIAL)
- **Authorized official phone:** (615) 920-7000

## Contact information

- **Practice address:** 30 TOWER CIR, SOMERSET, KY 42503-3476
- **Practice address phone:** (606) 451-8644
- **Practice address fax:** (606) 451-9644
- **Mailing address:** 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027
- **Mailing address phone:** (615) 920-7000
- **Mailing address fax:** (615) 920-8775

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/30/2011
- **Last updated:** 08/28/2019