Organization
CUMBERLAND SKIN SURGERY AND DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE COUNTESS MD (PRESIDENT)
(615) 449-5255
Entity
Organization
Contact information
Practice address
1405 W BADDOUR PKWY, SUITE 101, LEBANON, TN 37087-2567
(615) 449-5255
Mailing address
PO BOX 1172, LEBANON, TN 37088-1172
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
41873
TN
Other
Enumeration date
03/06/2007
Last updated
05/27/2009
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