Organization
CUMBERLAND FOOT & ANKLE CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN E MOORE (PRESIDENT/PODIATRIST)
(606) 679-2773
Entity
Organization
Contact information
Practice address
141 PROSPEROUS PL STE 22A, LEXINGTON, KY 40509-1854
(859) 263-2230
(859) 263-8641
Mailing address
117 TRADEPARK DR STE B, SOMERSET, KY 42503-3428
(606) 679-2773
(606) 679-4626
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100207030
—
KY
05
—
7100234690
—
KY
Enumeration date
02/13/2018
Last updated
02/13/2018
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