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Organization

SOUTHFORK MEDICAL CLINIC PLLC

Active
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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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