Organization · Type 2 NPI

Pinelake Physician Practice, LLC

Rural Health Clinic/Center · Mayfield, KY

NPI number 1295960532 Active

Practice location

1111 Medical Center Cir
Mayfield, KY 42066-1194

Call (270) 251-4543 Map

Fax (270) 251-4544

Mailing address

330 Seven Springs Way, Atten: Provider Enrollment
Brentwood, TN 37027-5098

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000XNone listed
Rural Health Clinic/Center Primary 261QR1300XNone listed

Rural Health Clinic/Center: Definition to come...

26 other providers at this address

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About NPI 1295960532

Pinelake Physician Practice, LLC's National Provider Identifier is 1295960532, issued on May 15, 2009. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Mayfield, KY. The record was last updated on Jul 16, 2026.