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Organization

CUMBERLAND OTOLARYNGOLOGY CONSULTANTS, PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVIN T KAVANAGH M.D. (PHYSICIAN)
(606) 679-7426
Entity
Organization

Contact information

Practice address
402 BOGLE ST STE 3, SOMERSET, KY 42503-2870
(606) 679-7426
(606) 679-7745
Mailing address
402 BOGLE ST STE 3, SOMERSET, KY 42503-2870
(606) 679-7426
(606) 679-7745

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
65926917
KY
05
78901881
KY
Enumeration date
12/26/2006
Last updated
08/21/2007
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