PINELAKE PHYSICIAN PRACTICE, LLC

MAYFIELD, KY
NPI1295960532
Entity TypeOrganization
Authorized ContactMONICA BOWMAN
Sr. Director
615-920-7000
Organization Subpart ?No
Primary Taxonomy261QR1300X Clinic/Center, Rural Health
Additional Taxonomies207Q00000X Family Medicine
Enumeration Date2009-05-15
Last Update Date2023-05-08
Business Address
PINELAKE PHYSICIAN PRACTICE, LLC
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066-1194
Phone number: 270-251-4543
Mailing Address
PINELAKE PHYSICIAN PRACTICE, LLC
330 SEVEN SPRINGS WAY ATTEN: PROVIDER ENROLLMENT
BRENTWOOD, TN 37027-5098
Phone number: 615-920-7192