PINELAKE PHYSICIAN PRACTICE LLC is a rural health clinic center in Hickman, KY. PINELAKE PHYSICIAN PRACTICE LLC NPI is 1205494085. The provider is registered as an organization entity type. The provider Is Doing Business As Jackson Purchase Primary Care Hickman Clinic.
The provider's business location address is:
2003 S 7TH ST HICKMAN, KY ZIP 42050-841 Phone: (270) 236-3337 Fax: (270) 236-3340
The provider's authorized official is Terrance K. Dillon . The authorized official title is Assistant Secretary and has the following contact phone number (502) 596-7220.
The CLIA number assigned to this NPI record is 18D2106420 - rural health clinic with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/5/2019 and was last updated on 8/24/2022.
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.
This page was last updated on: 11/21/2025
NPI Synchronization or Removal
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