Organization
PINELAKE PHYSICIAN PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAWRENCE (ASSISTANT CORPORATE SECRETARY)
(615) 920-7688
Entity
Organization
Contact information
Practice address
1029 MEDICAL CENTER CIR STE 204, MAYFIELD, KY 42066-1189
(270) 251-4545
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/25/2022
Last updated
11/25/2022
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