Cumberland Gi, Psc | |
1710 Cumberland Falls Hwy Corbin KY 40701-2727 | |
(606) 528-6700 | |
(606) 528-6513 |
Full Name | Cumberland Gi, Psc |
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Speciality | Internal Medicine |
Location | 1710 Cumberland Falls Hwy, Corbin, Kentucky |
Authorized Official Name and Position | Michael E Simons (OWNER/PRESIDENT) |
Authorized Official Contact | 6065286700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Cumberland Gi, Psc 1710 Cumberland Falls Hwy Corbin KY 40701-2727 Ph: (606) 528-6700 | Cumberland Gi, Psc 1710 Cumberland Falls Hwy Corbin KY 40701-2727 Ph: (606) 528-6700 |
NPI Number | 1578557708 |
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Provider Enumeration Date | 09/02/2005 |
Last Update Date | 05/09/2017 |
Medicare PECOS PAC ID | 0143291559 |
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Medicare Enrollment ID | O20040802000136 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578557708 | NPI | - | NPPES |
65932063 | Medicaid | KY | |
7100001390 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
Provider Name | Janice L Hedayati |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861648065 PECOS PAC ID: 4183788219 Enrollment ID: I20090204000045 |
Provider Name | Michael E Simons |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1265433015 PECOS PAC ID: 1759352164 Enrollment ID: I20110301000603 |
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