PINELAKE PHYSICIAN PRACTICE LLC

MAYFIELD, KY
NPI1093609612
Doing Business AsJACKSON PURCHASE PRIMARY CARE - SOUTHSIDE CLINIC
Entity TypeOrganization
Authorized ContactCHARLOTTE LAWRENCE
Secretary
615-920-7000
Organization Subpart ?No
Primary Taxonomy261QR1300X Clinic/Center, Rural Health
Enumeration Date2025-06-06
Last Update Date2025-06-06
Business Address
PINELAKE PHYSICIAN PRACTICE LLC
1206 PARIS RD STE B
MAYFIELD, KY 42066-4989
Phone number: 270-804-7160
Mailing Address
PINELAKE PHYSICIAN PRACTICE LLC
330 SEVEN SPRINGS WAY
BRENTWOOD, TN 37027-5098
Phone number: 615-920-7000