Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lily Creek Medical Group, PSC

Organization Internal Medicine Physician · NPI 1205987542

Lily Creek Medical Group, PSC is an Internal Medicine Physician in Russell Springs, Kentucky. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
3
What do these letters mean?
PSC — Professional service corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

92 Joe T Petty Dr
Russell Springs, KY 42642-8543
Phone: (270) 866-8881
Fax: (270) 866-8849
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Nurse Practitioner Taxonomy 363L00000X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1205987542
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Bertram — President · (270) 866-8881
NPI enumeratedJanuary 15, 2007
Last updated in NPPESOctober 30, 2008
Mailing addressPo Box 5007, Frankfort, KY 40602-5007

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