Medical school: UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Graduated: 2009
NPI: 1851613228
Practice Locations (3)
SOUTHFORK MEDICAL CLINIC PLLC
57 MEDICAL LANE
WHITLEY CITY, KY 426534216
6063767211
SOUTHFORK MEDICAL CLINIC PLLC
71 MEDICAL LN
WHITLEY CITY, KY 426534216
6063767212
SOUTHFORK MEDICAL CLINIC PLLC
PO BOX
WHITLEY CITY, KY 42653
Source: CMS National Downloadable File, September 2026.