Magnolia Family Practice Psc

NPI #1245284777 in Mayfield, Kentucky

Provider Information

NPI Number: 1245284777
Entity Type: Organization
Organization Name: Magnolia Family Practice Psc
Primary Specialty: Family Medicine
Enumeration Date: May 20, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1029 MEDICAL CENTER CIR
Address 2: SUITE 200
City: Mayfield
State: Kentucky
ZIP Code: 42066-1189
Phone: (270) 251-4545

Authorized Official

Name: KATHRYN J GLASS, MD
Title: PHYSICIAN/OWNER
Phone: (270) 251-4545

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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