Organization
CUMBERLAND ORTHOPAEDICS AND SPORTS MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN M. PAGE' M.D. (PRESIDENT OWNER)
(606) 864-0770
Entity
Organization
Contact information
Practice address
160 LONDON MOUNTAIN VIEW DR, LONDON, KY 40741-6601
(606) 864-0770
(606) 864-1461
Mailing address
160 LONDON MOUNTAIN VIEW DR, LONDON, KY 40741-6601
(606) 864-0770
(606) 864-1461
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
00308
KY
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164304800
WORKERS COMPENSATION
—
05
—
65933327
—
KY
05
—
7890447100
—
KY
05
—
95901328
—
KY
01
—
CB6337
RAILROAD MEDICARE
—
Enumeration date
05/05/2006
Last updated
04/13/2009
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