# CUMBERLAND ORTHOPAEDIC & SPORTS MEDINCE-PHYSICIAN ASSISTANT

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CUMBERLAND ORTHOPAEDIC & SPORTS MEDICINE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902049356
- **Legal business name:** CUMBERLAND ORTHOPAEDIC & SPORTS MEDICINE
- **Authorized official:** MR. JEAN M PAGE' M.D. (PRESIDENT OWNER)
- **Authorized official phone:** (606) 864-0770

## Contact information

- **Practice address:** 160 LONDON MOUNTAIN VIEW DR, LONDON, KY 40741-6601
- **Practice address phone:** (606) 864-0770
- **Practice address fax:** (606) 864-1461
- **Mailing address:** 160 LONDON MOUNTAIN VIEW DR, LONDON, KY 40741-6601
- **Mailing address phone:** (606) 864-0770
- **Mailing address fax:** (606) 864-1461

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA841 | KY | Yes |

## Other

- **Enumeration date:** 04/15/2009
- **Last updated:** 04/15/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 95901328 | — | KY |