Healthcare Provider Details

I. General information

NPI: 1558879007
Provider Name (Legal Business Name): CUMBERLAND SURGICAL ARTS AND ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2285 RUDOLPHTOWN ROAD SUITE 200
CLARKSVILLE TN
37043
US

IV. Provider business mailing address

2285 RUDOLPHTOWN ROAD SUITE 200
CLARKSVILLE TN
37043
US

V. Phone/Fax

Practice location:
  • Phone: 931-552-3292
  • Fax: 931-552-3243
Mailing address:
  • Phone: 931-552-3292
  • Fax: 931-552-3243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS0000008427
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS0000008953
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS0000009847
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS0000005220
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN011393
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number254190
License Number StateMS
# 7
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number50700
License Number StateKY
# 8
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberMD0000040738
License Number StateTN
# 9
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberMD0000040738
License Number StateTN

VIII. Authorized Official

Name: DR. GEORGE S LEE
Title or Position: DOCTOR
Credential: M.D., D.D.S
Phone: 931-552-3292