Organization
LAKE CUMBERLAND GASTROENTEROLOGY AND INTERNAL MEDICINE ASSOC. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA ROBACK (OFFICE MANAGER)
(606) 679-7317
Entity
Organization
Contact information
Practice address
110 HARDIN LN, SUITE 9, SOMERSET, KY 42503-3818
(606) 679-7317
(606) 679-0139
Mailing address
110 HARDIN LN, SUITE 9, SOMERSET, KY 42503-3818
(606) 679-7317
(606) 679-0139
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
KY
Other
Enumeration date
01/31/2007
Last updated
06/21/2011
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