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General NPI Number Information
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NPI Number | 1619117058
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Entity Type | Organization
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Legal Business Name | LAKE CUMBERLAND RHEUMATOLOGY, PLLC
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 26 OXFORD WAY STE A
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City | SOMERSET
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State | KY
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Zip | 42503-2813
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Country | US
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Telephone | 606-802-2300
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Fax | 502-874-5536
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Provider Business Mailing Address
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Address Line | 26 OXFORD WAY STE A
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City | SOMERSET
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State | KY
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Zip | 42503-2813
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Country | US
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Telephone | 606-802-2300
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Fax | 502-874-5536
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Authorized Official
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Title or Position | DO/OWNER
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Name | TIMOTHY ALLEN LONESKY
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Credential | DO
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Telephone | 304-415-5155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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