Southfork Medical Clinic Pllc
NPI #1205616265 in Whitley City, Kentucky
Provider Information
- NPI Number
- 1205616265
- Entity Type
- Organization
- Organization Name
- Southfork Medical Clinic Pllc
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Oct 5, 2023
- Last Updated
- Nov 25, 2025
Practice Location
- Address
- 57 MEDICAL LANE
- City
- Whitley City
- State
- Kentucky
- ZIP Code
- 42653
- Phone
- (606) 376-7211
Authorized Official
- Name
- VIRGINIA ANN CORRELL
- Title
- CREDENTIALING
- Phone
- (606) 376-7212
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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