Organization · NPI-2
Lake Cumberland Womens Health Specialists,psc
Obstetrics & Gynecology · Somerset, KY
NPI number1578600367
StatusActive
Last updated in NPPESApr 24, 2012
Details
- NPI
- 1578600367
- Entity type
- Organization (NPI-2)
- Legal business name
- Lake Cumberland Womens Health Specialists,psc
- Organization subpart
- No
- Enumeration date
- Jan 31, 2007
- Last updated
- Apr 24, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | – | KY | Yes |
| 363LX0001X | Nurse Practitioner, Obstetrics & Gynecology | – | KY |
Practice location
333 Bogle StSomerset, KY 42503-2873
Phone 606-678-0705 · Fax 606-678-2807
Mailing address
333 Bogle StSomerset, KY 42503-2873
Phone 606-678-0705 · Fax 606-678-2807
Authorized official
Dale Edward Rutledge
Physician Vp
6066780705
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