# UPPER CUMBERLAND RURAL HEALTH CLINIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TN PEDIATRIC AND ADOLESCENT CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679378079
- **Authorized official:** DR. PUSHPENDRA K JAIN MD (OWNER)
- **Authorized official phone:** (931) 528-8899

## Contact information

- **Practice address:** 435 N CEDAR AVE, COOKEVILLE, TN 38501-2422
- **Practice address phone:** (931) 526-6100
- **Mailing address:** 225 N WILLOW AVE STE 3, COOKEVILLE, TN 38501-2453

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/18/2025
- **Last updated:** 02/18/2025