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

Pinelake Physician Practice LLC

Organization Rural Health Clinic/Center · NPI 1093609612

Pinelake Physician Practice LLC is a Rural Health Clinic/Center in Mayfield, Kentucky. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1206 Paris Rd Ste B
Mayfield, KY 42066-4989
Phone: (270) 804-7160
Show map & directions

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

Specialties & licences

Rural Health Clinic/Center (primary) Taxonomy 261QR1300X

Record details

NPI number1093609612
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charlotte Lawrence — Secretary · (615) 920-7000
Other names Jackson Purchase Primary Care - Southside Clinic
NPI enumeratedJune 6, 2025
Last updated in NPPESJune 6, 2025
Certification dateJune 6, 2025
Mailing address330 Seven Springs Way, Brentwood, TN 37027-5098

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