PINELAKE PHYSICIAN PRACTICE LLC

MAYFIELD, KY
NPI1275178089
Doing Business AsJACKSON PURCHASE PRIMARY CARE HUSSAIN CLINIC
Entity TypeOrganization
Authorized ContactKATHY TEAGUE
Secretary
615-920-7000
Organization Subpart ?No
Primary Taxonomy261QR1300X Clinic/Center, Rural Health
Enumeration Date2019-11-15
Last Update Date2019-11-15
Business Address
PINELAKE PHYSICIAN PRACTICE LLC
417 S 6TH ST
MAYFIELD, KY 42066-2311
Phone number: 270-247-1104
Mailing Address
PINELAKE PHYSICIAN PRACTICE LLC
330 SEVEN SPRINGS WAY
BRENTWOOD, TN 37027-5098
Phone number: 615-920-7000