Healthcare Provider Details

I. General information

NPI: 1235242223
Provider Name (Legal Business Name): SOMERSET MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 TOWER CIR SUITE A
SOMERSET KY
42503-3476
US

IV. Provider business mailing address

10 TOWER CIR SUITE A
SOMERSET KY
42503-3476
US

V. Phone/Fax

Practice location:
  • Phone: 606-678-4288
  • Fax: 606-678-2230
Mailing address:
  • Phone: 606-678-4288
  • Fax: 606-678-2230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. DONALD BRENT CHERRY
Title or Position: OWNER
Credential: M.D.
Phone: 606-678-4288