Provider Demographics
NPI:1497263941
Name:CUMBERLAND SURGICAL ARTS AND ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:CUMBERLAND SURGICAL ARTS AND ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD,DDS
Authorized Official - Phone:931-552-3292
Mailing Address - Street 1:2285 RUDOLPHTOWN ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043
Mailing Address - Country:US
Mailing Address - Phone:931-552-3292
Mailing Address - Fax:931-552-3243
Practice Address - Street 1:1275 PARKWAY PLACE
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042
Practice Address - Country:US
Practice Address - Phone:931-552-3292
Practice Address - Fax:931-552-3243
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CUMBERLAND SURGICAL ARTS AND ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-18
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000084271223S0112X
TNDS00000089531223S0112X
TNDS00000098471223S0112X
TNDS00000052201223S0112X
GADN0113931223S0112X
MS2541901223S0112X
TNMD0000040738204E00000X, 2082S0099X
KY50700204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and NeckGroup - Multi-Specialty