Tyrone Lee Daniels (NPI# 1043264393, PAC ID# 4981517166) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIOVASCULAR DISEASE (CARDIOLOGY).
| Nation Provider ID (NPI) | 1043264393 |
| PAC ID by PECOS | 4981517166 |
| Professional Enrollment ID | I20040608001374 |
| Full Name | Tyrone Lee Daniels |
| Organization Legal Name | PINELAKE PHYSICIAN PRACTICE LLC |
| Address |
1111 Medical Ctr Cir Mayfield KY 42066-1194 |
| Phone Number | 2702514055 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF IOWA COLLEGE OF MEDICINE |
| Graduation Year | 1983 |
| Primary Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 6800797507 |
| Number of Group Practice Members | 32 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180116 | JACKSON PURCHASE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 | 2702514055 | PINELAKE PHYSICIAN PRACTICE LLC |
| Organization Legal Name | PINELAKE PHYSICIAN PRACTICE LLC |
| Physicians | 33 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy M Turner | Nurse Practitioner | Pinelake Physician Practice LLC | 106 W Clay St, Clinton, KY 42031-1317 |
| Sarah M Darnell | Nurse Practitioner | Pinelake Physician Practice LLC | 1029 Medical Ctr Cir, Mayfield, KY 42066-1189 |
| Lela Cole | Nurse Practitioner | Pinelake Physician Practice LLC | 110 S 9th St, Mayfield, KY 42066-2208 |
| Tanna S Vaughan | Nurse Practitioner | Pinelake Physician Practice LLC | 1029 Medical Ctr Cir, Mayfield, KY 42066-1189 |
| Jessica Little | Podiatry | Pinelake Physician Practice LLC | 1029 Medical Ctr Cir, Suite 401, Mayfield, KY 42066-1189 |
| Elias Pitaras | Nephrology | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| Melisha Danielle Baldwin | Obstetrics/gynecology | Pinelake Physician Practice LLC | 1029 Medical Ctr Cir, Mayfield, KY 42066-1189 |
| Jonathan A Wynstra | Obstetrics/gynecology | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| Wayne E Williams | Family Medicine | Pinelake Physician Practice LLC | 1029 Medical Ctr Cir, Mayfield, KY 42066-1189 |
| Pavan Bejgum | Internal Medicine | Pinelake Physician Practice LLC | 1029 Medical Ctr Cir, Mayfield, KY 42066-1189 |
| Street Address |
1111 MEDICAL CTR CIR |
| City | MAYFIELD |
| State | KY |
| Zip | 42066-1194 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elias Pitaras | Nephrology | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| Jonathan A Wynstra | Obstetrics/gynecology | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| Sandy K Riley | Nurse Practitioner | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| Janine K Kruger | Obstetrics/gynecology | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| Allie L Alexander Lusk | Nurse Practitioner | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| Michele A Stroud | Nurse Practitioner | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| Christopher D Dobrose | Family Medicine | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| Michelle Ann Jewell | Nurse Practitioner | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| Candace A Riehl | Certified Nurse Midwife | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| William Thistlethwaite | General Surgery | Pinelake Physician Practice LLC | 1111 Medical Ctr Cir, Mayfield, KY 42066-1194 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Laframboise | Physical Therapy | Atlas Physical Therapy LLC | 1413 Us Hwy 45, Mayfield, KY 42066 |
| Carla Ann Atherton | Certified Registered Nurse Anesthetist (crna) | Northstar Anesthesia of Kentucky, Pllc | 1099 Medical Ctr Circle, Mayfield, KY 42066-1143 |
| Lillian Silva | Certified Registered Nurse Anesthetist (crna) | Northstar Anesthesia of Kentucky, Pllc | 1099 Medical Ctr Circle, Mayfield, KY 42066-1143 |
| Myra F Mardis | Certified Registered Nurse Anesthetist (crna) | Northstar Anesthesia of Kentucky, Pllc | 1099 Medical Ctr Circle, Mayfield, KY 42066-1143 |
| Daniel A Ogaz | Certified Registered Nurse Anesthetist (crna) | Northstar Anesthesia of Kentucky, Pllc | 1099 Medical Ctr Circle, Mayfield, KY 42066-1143 |
| Rauf Murtaza | Anesthesiology | Northstar Anesthesia of Kentucky, Pllc | 1099 Medical Ctr Circle, Mayfield, KY 42066-1143 |
| Jonathan Embry | Certified Registered Nurse Anesthetist (crna) | Northstar Anesthesia of Kentucky, Pllc | 1099 Medical Ctr Circle, Mayfield, KY 42066-1143 |
| Mary Theresa Lancaster | Certified Registered Nurse Anesthetist (crna) | Northstar Anesthesia of Kentucky, Pllc | 1099 Medical Ctr Circle, Mayfield, KY 42066-1143 |
| Larry D Corn Jr. | Certified Registered Nurse Anesthetist (crna) | Northstar Anesthesia of Kentucky, Pllc | 1099 Medical Ctr Circle, Mayfield, KY 42066-1143 |
| Robert R Loughran | Certified Registered Nurse Anesthetist (crna) | Northstar Anesthesia of Kentucky, Pllc | 1099 Medical Ctr Circle, Mayfield, KY 42066-1143 |
| Find all physicians in zip 42066 | |||
| City | MAYFIELD |
| Zip Code | 42066 |
| Specialty | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| City + Specialty | MAYFIELD + CARDIOVASCULAR DISEASE (CARDIOLOGY) |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.