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General NPI Number Information
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NPI Number | 1548403991
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Entity Type | Organization
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Legal Business Name | CUMBERLAND ORTHOPAEDIC & SPORTS MEDICINE-ARNP
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Dates
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Enumeration Date | 04/15/2009
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 160 LONDON MOUNTAIN VIEW DR
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City | LONDON
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State | KY
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Zip | 40741-6601
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Country | US
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Telephone | 606-864-0770
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Fax | 606-864-1461
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Provider Business Mailing Address
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Address Line | 160 LONDON MOUNTAIN VIEW DR
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City | LONDON
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State | KY
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Zip | 40741-6601
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Country | US
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Telephone | 606-864-0770
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Fax | 606-864-1461
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. JEAN M PAGE'
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Credential | M.D.
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Telephone | 606-864-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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