Healthcare Provider Details

I. General information

NPI: 1558291526
Provider Name (Legal Business Name): TOMMY LANHAM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 CUMBERLAND FALLS HWY STE B106
CORBIN KY
40701-2794
US

IV. Provider business mailing address

1019 CUMBERLAND FALLS HWY STE B106
CORBIN KY
40701-2794
US

V. Phone/Fax

Practice location:
  • Phone: 606-521-8100
  • Fax: 606-620-9250
Mailing address:
  • Phone: 606-521-8100
  • Fax: 606-620-9250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: