# UPPER CUMBERLAND RURAL HEALTH CLINIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cookeville Medical Clinic Gainesboro RHC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891007431
- **Authorized official:** DR. PUSHPENDRA JAIN MD (CEO)
- **Authorized official phone:** (931) 528-8899

## Contact information

- **Practice address:** 402 E GORE AVE, GAINESBORO, TN 38562-9367
- **Practice address phone:** (931) 268-6899
- **Practice address fax:** (931) 858-8650
- **Mailing address:** 225 N WILLOW AVE, COOKEVILLE, TN 38501-2335
- **Mailing address phone:** (931) 528-8899
- **Mailing address fax:** (931) 284-4085

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | 448904 | TN | Yes |

## Other

- **Enumeration date:** 07/12/2010
- **Last updated:** 11/09/2022