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

Pinelake Physician Practice, LLC

Organization Family Medicine Physician · NPI 1295960532

Pinelake Physician Practice, LLC is a Family Medicine Physician in Mayfield, Kentucky. Registered with an NPI since 2009.

In the registry since
2009
Specialties on file
2
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

1111 Medical Center Cir
Mayfield, KY 42066-1194
Phone: (270) 251-4543
Fax: (270) 251-4544
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
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1295960532
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charlotte Lawrence — Secretary · (615) 920-7688
NPI enumeratedMay 15, 2009
Last updated in NPPESJuly 16, 2026
Certification dateJuly 16, 2026
Mailing address330 Seven Springs Way, Atten: Provider Enrollment, Brentwood, TN 37027-5098

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