PINELAKE PHYSICIAN PRACTICE LLC

CLINTON, KY
NPI1437614633
Doing Business AsJACKSON PURCHASE PRIMARY CARE - CLINTON CLINIC
Entity TypeOrganization
Authorized ContactSHARLEE LEBLEU
Sr Director, Provider Enrollment
615-920-7192
Organization Subpart ?No
Primary Taxonomy261QR1300X Clinic/Center, Rural Health
Additional Taxonomies363L00000X Nurse Practitioner
363LF0000X Nurse Practitioner, Family
207Q00000X Family Medicine
207VX0000X Obstetrics & Gynecology, Obstetrics
Enumeration Date2019-02-01
Last Update Date2019-06-11
Business Address
PINELAKE PHYSICIAN PRACTICE LLC
106 W CLAY ST
CLINTON, KY 42031-1317
Phone number: 270-653-0220
Mailing Address
PINELAKE PHYSICIAN PRACTICE LLC
330 SEVEN SPRINGS WAY
BRENTWOOD, TN 37027-5098
Phone number: 615-920-7192