Organization · Type 2 NPI

Pinelake Physician Practice, LLC

Internal Medicine Physician · Mayfield, KY

NPI number 1861563439 Active

Practice location

1029 Medical Center Cir
Mayfield, KY 42066-1189

Call (270) 251-4590 Map

Fax (270) 251-4591

Mailing address

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

Other practice locations

  • 101 Main St, Fulton, KY 42041-1601 · (270) 472-5245
  • 2003 S 7th St, Hickman, KY 42050-1841

Specialties and licenses

TaxonomyCodeLicense
Lactation Consultant (Registered Nurse) 163WL0100XNone listed
Family Medicine Physician 207Q00000XNone listed
Internal Medicine Physician Primary 207R00000XNone listed
Cardiovascular Disease Physician 207RC0000XNone listed
Orthopaedic Surgery Physician 207X00000XNone listed
Facial Plastic Surgery Physician 207YS0123XNone listed
Neurology Physician 2084N0400XNone listed
Diagnostic Radiology Physician 2085R0202XNone listed
Surgery Physician 208600000XNone listed
Vascular Surgery Physician 2086S0129XNone listed
Foot & Ankle Surgery Podiatrist 213ES0103XNone listed
Durable Medical Equipment & Medical Supplies 332B00000XNone listed
Physician Assistant 363A00000XNone listed
Nurse Practitioner 363L00000XNone listed
Certified Registered Nurse Anesthetist 367500000XNone listed

Internal Medicine Physician: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medi…

27 other providers at this address

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About NPI 1861563439

Pinelake Physician Practice, LLC's National Provider Identifier is 1861563439, issued on Nov 13, 2006. The primary taxonomy on file is Internal Medicine Physician (207R00000X), and the practice location is in Mayfield, KY. The record was last updated on Jan 7, 2026.