Organization
SOUTHFORK MEDICAL CLINIC PLLC
Active
Other names
SOUTH FORK CLINIC PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA ANN CORRELL (CREDENTIALING)
(606) 376-7212
Entity
Organization
Contact information
Practice address
57 MEDICAL LANE, WHITLEY CITY, KY 42653
(606) 376-7211
(606) 376-9219
Mailing address
PO BOX 490, WHITLEY CITY, KY 42653-0490
(606) 376-7211
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/05/2023
Last updated
11/25/2025
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