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Organization

LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC

Active
Other names
Lake Cumberland Urology Associates
Organization subpart
No

Provider details

NPI number
Authorized official
SARA MILLER (DIRECTOR)
(615) 920-7514
Entity
Organization

Contact information

Practice address
30 MEDPARK SQUARE, SUITE 1, SOMERSET, KY 42503-1709
(606) 451-0485
(606) 451-0229
Mailing address
PO BOX 719, SOMERSET, KY 42502-0719
(606) 451-0485
(606) 451-0229

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
363A00000X
Physician Assistant

Other

Enumeration date
09/22/2015
Last updated
09/27/2017
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