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

Pinelake Physician Practice LLC

Organization Family Medicine Physician · NPI 1912216532

Pinelake Physician Practice LLC is a Family Medicine Physician in Mayfield, Kentucky. Registered with an NPI since 2010.

In the registry since
2010
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) 251-4085
Fax: (270) 251-4086
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Sports Medicine (Family Medicine) Physician Taxonomy 207QS0010X

Record details

NPI number1912216532
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Denis Miller — Regional Director · (615) 934-1454
Other names Jackson Purchase Family And Sports Medicine
NPI enumeratedSeptember 30, 2010
Last updated in NPPESSeptember 30, 2010
Mailing address1029 Medical Center Cir, Mayfield, KY 42066-1189

Other providers in Mayfield