Organization
PINELAKE PHYSICIAN PRACTICES LLC
Active
Other names
Jackson Purchase Nephrology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS WEISS (DIVISION PRESIDENT)
(615) 375-8500
Entity
Organization
Contact information
Practice address
1029 MEDICAL CENTER CIR, SUITE 200 A, MAYFIELD, KY 42066-1189
(270) 251-4545
(270) 251-4546
Mailing address
1029 MEDICAL CENTER CIR, SUITE 200 A, MAYFIELD, KY 42066-1189
(270) 251-4545
(270) 251-4546
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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