Healthcare Provider Details

I. General information

NPI: 1427242544
Provider Name (Legal Business Name): NORMAN A. CUMMINGS, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1169 EASTERN PKWY SUITE 3451
LOUISVILLE KY
40217-1417
US

IV. Provider business mailing address

1169 EASTERN PKWY SUITE 3451
LOUISVILLE KY
40217-1417
US

V. Phone/Fax

Practice location:
  • Phone: 502-479-9700
  • Fax: 502-479-9705
Mailing address:
  • Phone: 502-479-9700
  • Fax: 502-479-9705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number17722
License Number StateKY

VIII. Authorized Official

Name: DR. NORMAN ALLEN CUMMINGS
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 502-479-9700