PINELAKE PHYSICIAN PRACTICE, LLC

MAYFIELD, KY
NPI1861563439
Doing Business AsJACKSON PURCHASE PODIATRY
Entity TypeOrganization
Authorized ContactCHARLOTTE LAWRENCE
Secretary
615-920-7000
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies363L00000X Nurse Practitioner
332B00000X Durable Medical Equipment & Medical Supplies
207RC0000X Internal Medicine, Cardiovascular Disease
207X00000X Orthopaedic Surgery
207Q00000X Family Medicine
207YS0123X Otolaryngology, Facial Plastic Surgery
213ES0103X Podiatrist, Foot & Ankle Surgery
208600000X Surgery
2086S0129X 
2084N0400X Psychiatry & Neurology, Neurology
363A00000X Physician Assistant
2085R0202X Radiology, Diagnostic Radiology
163WL0100X Registered Nurse, Lactation Consultant
367500000X Nurse Anesthetist, Certified Registered
Enumeration Date2006-11-13
Last Update Date2026-01-07
Business Address
PINELAKE PHYSICIAN PRACTICE, LLC
1029 MEDICAL CENTER CIR
MAYFIELD, KY 42066-1189
Phone number: 270-251-4590
Mailing Address
PINELAKE PHYSICIAN PRACTICE, LLC
330 SEVEN SPRINGS WAY ATTEN PROVIDER ENROLLMENT
BRENTWOOD, TN 37027-5098
Phone number: 615-920-7000