Healthcare Provider Details

I. General information

NPI: 1922160100
Provider Name (Legal Business Name): CUMBERLAND HEALTH CARE GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 HOSPITAL RD
WINCHESTER TN
37398-2404
US

IV. Provider business mailing address

66 SUNRISE PARK
WINCHESTER TN
37398-2345
US

V. Phone/Fax

Practice location:
  • Phone: 931-962-4061
  • Fax: 931-962-3343
Mailing address:
  • Phone: 931-962-4061
  • Fax: 931-962-3004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: STEVEN S STEWART
Title or Position: ADMINISTRATOR
Credential:
Phone: 931-962-4061