# LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pain Center of Lake Cumberland
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730489840
- **Authorized official:** SARA MILLER (DIRECTOR)
- **Authorized official phone:** (615) 920-7514

## Contact information

- **Practice address:** 305 LANGDON STREET, SUITE P, SOMERSET, KY 42503
- **Practice address phone:** (606) 676-0206
- **Practice address fax:** (606) 676-0220
- **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 |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/25/2010
- **Last updated:** 09/27/2017