OrganizationActive
Pinelake Physician Practice LLC
NPI 1255650479 · Otolaryngology/Facial Plastic Surgery Physician · Mayfield, KY
Provider details
- NPI number
- 1255650479
- Entity type
- Organization
- Primary specialty
- Otolaryngology/Facial Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Timothy Vaughn, Vice President(615) 372-8500
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1111 Medical Center Cir
Mayfield, KY 42066-1194
Phone: (270) 251-4080
Fax: (270) 251-4081
Approximate (ZIP-level) locationGet directions
Mailing address
1029 Medical Center Cir
Mayfield, KY 42066-1189
Other names (DBA / former)
- Doing business as
- Jackson Purchase Ent & Aesthetic Surgery
Registry dates
- Enumerated
- 2010-05-27
- Last updated
- 2010-05-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.