PINELAKE PHYSICIAN PRACTICE, LLC

HICKMAN, KY
NPI1861563439
Entity TypeOrganization
Authorized ContactMONICA BOWMAN
President
615-920-7000
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies163WL0100X Registered Nurse, Lactation Consultant
207Q00000X Family Medicine
207RC0000X Internal Medicine, Cardiovascular Disease
207X00000X Orthopaedic Surgery
207YS0123X Otolaryngology, Facial Plastic Surgery
2084N0400X Psychiatry & Neurology, Neurology
2085R0202X Radiology, Diagnostic Radiology
208600000X Surgery
2086S0129X Surgery, Vascular Surgery
213ES0103X Podiatrist, Foot & Ankle Surgery
332B00000X Durable Medical Equipment & Medical Supplies
363A00000X Physician Assistant
363L00000X Nurse Practitioner
367500000X Nurse Anesthetist, Certified Registered
Enumeration Date2006-11-13
Last Update Date2023-07-13
Business Address
PINELAKE PHYSICIAN PRACTICE, LLC
2003 S 7TH ST
HICKMAN, KY 42050-1841
Phone number:
Mailing Address
PINELAKE PHYSICIAN PRACTICE, LLC
330 SEVEN SPRINGS WAY ATTEN PROVIDER ENROLLMENT
BRENTWOOD, TN 37027-5098
Phone number: 615-920-7000