Organization
LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC
Active
Other names
Pain Center of Lake Cumberland
Organization subpart
No
Provider details
NPI number
Authorized official
SARA MILLER (DIRECTOR)
(615) 920-7514
Entity
Organization
Contact information
Practice address
305 LANGDON STREET, SUITE P, SOMERSET, KY 42503
(606) 676-0206
(606) 676-0220
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027
(615) 920-7000
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100143770
—
KY
Enumeration date
10/25/2010
Last updated
09/27/2017
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