Organization
LAKE CUMBERLAND PHYSICIAN PRACTICES LLC
Active
Other names
Daniel R Yanicko Jr MD
Organization subpart
No
Provider details
NPI number
Authorized official
SARA MILLER (DIRECTOR)
(615) 920-7514
Entity
Organization
Contact information
Practice address
353 BOGLE ST, SUITE B, SOMERSET, KY 42503-2888
(606) 678-2663
(606) 678-0576
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027
(615) 920-7000
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/01/2013
Last updated
09/27/2017
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