Organization
PINELAKE PHYSICIAN PRACTICE LLC
Active
Other names
Jackson Purchase Primary Care - Southside Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAWRENCE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
1206 PARIS RD STE B, MAYFIELD, KY 42066-4989
(270) 804-7160
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/06/2025
Last updated
06/06/2025
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