Organization
CUMBERLAND FOOT AND ANKLE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN E MOORE DPM (OWNER/PODIATRIST)
(606) 679-2773
Entity
Organization
Contact information
Practice address
475 N HIGHWAY 25 W, SUITE 101, WILLIAMSBURG, KY 40769-1576
(606) 679-2773
(606) 679-4626
Mailing address
117 TRADEPARK DR, SOMERSET, KY 42503-3428
(606) 679-2773
(606) 679-4626
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90005091
—
KY
Enumeration date
08/25/2010
Last updated
08/25/2010
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