Provider Demographics
NPI:1821127010
Name:CUMBERLAND SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:CUMBERLAND SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:HOSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FALLAHZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-679-5161
Mailing Address - Street 1:26 OXFORD WAY STE A
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2813
Mailing Address - Country:US
Mailing Address - Phone:606-679-5161
Mailing Address - Fax:606-679-9308
Practice Address - Street 1:26 OXFORD WAY STE A
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2813
Practice Address - Country:US
Practice Address - Phone:606-679-5161
Practice Address - Fax:606-679-9308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1698Medicare ID - Type UnspecifiedGROUP NUMBER