Organization
LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC
Active
Other names
Cardiothoracic Surgical Associates of Lake Cumberland
Organization subpart
No
Provider details
NPI number
Authorized official
SARA MILLER (DIRECTOR)
(615) 920-7514
Entity
Organization
Contact information
Practice address
120 TRADEPARK DR, SUITE B, SOMERSET, KY 42503-3454
(606) 451-0300
(606) 451-0595
Mailing address
120 TRADEPARK DR, SUITE B, SOMERSET, KY 42503-3454
(606) 451-0300
(606) 451-0595
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
02/13/2009
Last updated
09/27/2017
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