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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