| Pinelake Physician Practice, Llc | |
|
1029 Medical Center Cir Ste 204 Mayfield KY 42066-1189 | |
| (270) 251-4545 | |
| Not Available |
| Full Name | Pinelake Physician Practice, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1029 Medical Center Cir Ste 204, Mayfield, Kentucky |
| Authorized Official Name and Position | Charlotte Lawrence (ASSISTANT CORPORATE SECRETARY) |
| Authorized Official Contact | 6159207688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinelake Physician Practice, Llc 330 Seven Springs Way Brentwood TN 37027-5098 Ph: (615) 920-7000 | Pinelake Physician Practice, Llc 1029 Medical Center Cir Ste 204 Mayfield KY 42066-1189 Ph: (270) 251-4545 |
| NPI Number | 1841900347 |
|---|---|
| Provider Enumeration Date | 11/25/2022 |
| Last Update Date | 11/25/2022 |
| Medicare PECOS PAC ID | 6800797507 |
|---|---|
| Medicare Enrollment ID | O20230125002844 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841900347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Dr Shah Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 W Water St, Mayfield, KY 42066 Phone: 270-247-2100 Fax: 270-247-2113 | |
Kentuckycare 63 Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 Kings Dr, Mayfield, KY 42066 Phone: 270-804-7710 Fax: 270-804-7722 | |
Mayfield Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 417 S 6th St, Mayfield, KY 42066 Phone: 270-247-1104 Fax: 270-247-1107 | |
Magnolia Family Practice Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1029 Medical Center Cir, Suite 200, Mayfield, KY 42066 Phone: 270-251-4545 Fax: 270-251-4546 | |
Pinelake Physician Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 417 S 6th St, Mayfield, KY 42066 Phone: 270-247-1104 | |
Pinelake Physician Practice, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1111 Medical Center Cir, Mayfield, KY 42066 Phone: 270-251-4543 Fax: 270-251-4544 | |
Dale E. Jones, Md Psc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1029 Medical Center Cir, Mayfield, KY 42066 Phone: 270-251-4545 Fax: 270-251-4546 |