Provider Demographics
NPI:1275543209
Name:CUMBERLAND CLINIC, PC
Entity Type:Organization
Organization Name:CUMBERLAND CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:DRAPER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:423-743-5194
Mailing Address - Street 1:630 ONEEGA LN
Mailing Address - Street 2:SUITE D
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-2197
Mailing Address - Country:US
Mailing Address - Phone:423-743-5194
Mailing Address - Fax:423-743-7125
Practice Address - Street 1:630 ONEEGA LN
Practice Address - Street 2:SUITE D
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-2197
Practice Address - Country:US
Practice Address - Phone:423-743-5194
Practice Address - Fax:423-743-7125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty