Organization Active NPI

Cumberland Surgical Arts, PLLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Clarksville, TN
National Provider Identifier
1730133695
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
CUMBERLAND SURGICAL ARTS, PLLC
Practice address
2285 Rudolphtown Rd
Suite 200
Clarksville, TN 37043
Phone
(931) 552-3292
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. George S Lee, MD, DDS
Title
Ceo
Phone
(615) 293-8651

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X SINGLE SPECIALTY GROUP 204E00000X Primary

Addresses

Primary practice location

2285 Rudolphtown Rd
Suite 200
Clarksville, TN 37043

Mailing address

PO Box 3097
Clarksville, TN 37043-3097
Phone (931) 552-3292

Other identifiers 1

IdentifierTypeStateIssuer
3733886MedicaidTN

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203897600000",
    "number": "1730133695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3097",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370433097",
            "telephone_number": "931-552-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 RUDOLPHTOWN RD",
            "address_2": "SUITE 200",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37043",
            "telephone_number": "931-552-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND SURGICAL ARTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2008-02-25",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-293-8651",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DDS"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3733886",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.