Graduated: 2012
NPI: 1023357928
Practice Locations (2)
PINELAKE PHYSICIAN PRACTICE LLC
1029 MEDICAL CTR CIR
MAYFIELD, KY 420661189
PINELAKE PHYSICIAN PRACTICE LLC
1099 MEDICAL CTR CIR
MAYFIELD, KY 420661179
2702514250
Source: CMS National Downloadable File, September 2026.