Organization
CUMBERLAND RADIOLOGY GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES STALLWORTH (PRESIDENT)
(931) 484-0048
Entity
Organization
Contact information
Practice address
421 S MAIN ST, CROSSVILLE, TN 38555-5048
(931) 484-9511
Mailing address
PO BOX 3139, CROSSVILLE, TN 38557-3139
(931) 484-0048
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962510529
NPI
—
05
—
3386332
—
TN
01
—
CC1089
RR MEDICARE
—
Enumeration date
08/25/2006
Last updated
03/16/2012
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