Provider Demographics
NPI:1205568003
Name:CUMBERLAND PEDIATRIC ASSOCIATES PC
Entity type:Organization
Organization Name:CUMBERLAND PEDIATRIC ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-453-1252
Mailing Address - Street 1:8 NEW MIDDLETON HWY
Mailing Address - Street 2:
Mailing Address - City:GORDONSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38563-6603
Mailing Address - Country:US
Mailing Address - Phone:615-683-4200
Mailing Address - Fax:615-683-4207
Practice Address - Street 1:8 NEW MIDDLETON HWY
Practice Address - Street 2:
Practice Address - City:GORDONSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38563-6603
Practice Address - Country:US
Practice Address - Phone:615-683-4200
Practice Address - Fax:615-683-4207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center