Organization
CUMBERLAND RADIATION ONCOLOGY, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMTULLAH KHAN M.D. (PRESIDENT)
(606) 451-3755
Entity
Organization
Contact information
Practice address
112 TRADEPARK DR, SOMERSET, KY 42503-3424
(606) 451-3755
(606) 451-3756
Mailing address
112 TRADEPARK DR, SOMERSET, KY 42503-3424
(606) 451-3755
(606) 451-3756
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
27622
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000220075
ANTHEM PIN
KY
01
—
2400015
UNITED HEALTHCARE PIN
KY
05
—
65937245
—
KY
01
—
C89965
BLUEGRASS FAMILY HEALTH
KY
Enumeration date
07/28/2005
Last updated
08/22/2020
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