Organization
PINELAKE PHYSICIAN PRACTICE LLC
Active
Organization
PINELAKE PHYSICIAN PRACTICE LLC
Active
Other names
Jackson Purchase Primary Care Williams Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SARA MILLER (DIRECTOR)
(615) 202-9581
Entity
Organization
Contact information
Practice address
110 S 9TH ST, MAYFIELD, KY 42066-2208
(270) 247-7795
(270) 247-2602
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7905
(615) 920-8935
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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