Provider Demographics
NPI:1669586806
Name:CUMBERLAND LUNG & SLEEP SPECIALISTS, PSC.
Entity type:Organization
Organization Name:CUMBERLAND LUNG & SLEEP SPECIALISTS, PSC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:RODRIGUES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-677-9793
Mailing Address - Street 1:143A BOGLE OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2810
Mailing Address - Country:US
Mailing Address - Phone:606-677-9793
Mailing Address - Fax:606-677-9795
Practice Address - Street 1:143A BOGLE OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2810
Practice Address - Country:US
Practice Address - Phone:606-677-9793
Practice Address - Fax:606-677-9795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33421207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65933004Medicaid
KY5991Medicare ID - Type Unspecified
KY5993Medicare UPIN
KY65933004Medicaid
KY5992Medicare UPIN