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Organization

LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SARA MILLER (DIRECTOR)
(615) 920-7514
Entity
Organization

Contact information

Practice address
350 HOSPITAL WAY STE 100, SOMERSET, KY 42503-1872
(606) 451-6886
Mailing address
103 POWELL CT STE 200, BRENTWOOD, TN 37027-5079
(615) 372-8500

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
208600000X
Surgery Physician
Primary
208D00000X
General Practice Physician

Other

Enumeration date
07/05/2007
Last updated
09/27/2017
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