| Pinelake Physician Practice Llc | |
|
106 W Clay St Clinton KY 42031-1317 | |
| (270) 653-0220 | |
| (270) 653-0221 |
| Full Name | Pinelake Physician Practice Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 106 W Clay St, Clinton, Kentucky |
| Authorized Official Name and Position | Sharlee Lebleu (SR DIRECTOR, PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6159207192 |
| 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) 920-7192 | Pinelake Physician Practice Llc 106 W Clay St Clinton KY 42031-1317 Ph: (270) 653-0220 |
| NPI Number | 1437614633 |
|---|---|
| Provider Enumeration Date | 02/01/2019 |
| Last Update Date | 06/11/2019 |
| Medicare PECOS PAC ID | 6800797507 |
|---|---|
| Medicare Enrollment ID | O20210514000883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437614633 | NPI | - | NPPES |
Jo-ann N. Bolli, M. D., P.s.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 S Washington St, Suite 201, Clinton, KY 42031 Phone: 270-653-4070 Fax: 270-653-4007 | |
Hospital Of Fulton Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 W Clay St, Clinton, KY 42031 Phone: 270-653-6277 Fax: 270-653-4097 | |
Hospital Of Fulton Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 351 Moss Dr, Clinton, KY 42031 Phone: 270-653-6277 | |
Arcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 308 S Washington St Ste 200, Clinton, KY 42031 Phone: 270-913-2478 Fax: 270-913-2479 | |
Communtiy Healthcare Of Western Kentucky Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 South Washington Street Suite 200, Clinton, KY 42031 Phone: 270-653-0220 Fax: 270-653-0221 |