Healthcare Provider Details

I. General information

NPI: 1992436216
Provider Name (Legal Business Name): UPPERLINE HEALTHCARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2022
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 CUMBERLAND FALLS HWY
CORBIN KY
40701-2714
US

IV. Provider business mailing address

4101 CHARLOTTE AVE STE F185
NASHVILLE TN
37209-4066
US

V. Phone/Fax

Practice location:
  • Phone: 606-258-8637
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL KING
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 407-219-5402