Organization
LAKE CUMBERLAND PHYSICIAN PRACTICES
Active
Other names
Lake Cumberland Weight Loss Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY D VAUGHN (VICE PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
154 BOGLE OFFICE PARK DR, SUITE A, SOMERSET, KY 42503-2810
(606) 425-4695
(606) 425-4696
Mailing address
PO BOX 719, SOMERSET, KY 42502-0719
(606) 425-4695
(606) 425-4696
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
04/12/2012
Last updated
10/21/2016
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