| Magnolia Family Practice Psc | |
|
1029 Medical Center Cir Suite 200 Mayfield KY 42066-1189 | |
| (270) 251-4545 | |
| (270) 251-4546 |
| Full Name | Magnolia Family Practice Psc |
|---|---|
| Speciality | Family Medicine |
| Location | 1029 Medical Center Cir, Mayfield, Kentucky |
| Authorized Official Name and Position | Kathryn J Glass (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2702514545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Family Practice Psc 1029 Medical Center Cir Suite 200 Mayfield KY 42066-1189 Ph: (270) 251-4545 | Magnolia Family Practice Psc 1029 Medical Center Cir Suite 200 Mayfield KY 42066-1189 Ph: (270) 251-4545 |
| NPI Number | 1245284777 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245284777 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 38858 (Kentucky) | Primary |
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