Magnolia Family Practice PSC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

38858 Issued in KY

Legal business name

MAGNOLIA FAMILY PRACTICE PSC

Practice address

1029 Medical Center Cir
Suite 200
Mayfield, KY 42066-1189

Phone

(270) 251-4545

Fax

(270) 251-4546

NPI assigned

May 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathryn J Glass, MD

Title

Physician/Owner

Phone

(270) 251-4545

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245284777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 MEDICAL CENTER CIR",
            "address_2": "SUITE 200",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661189",
            "telephone_number": "270-251-4545",
            "fax_number": "270-251-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 MEDICAL CENTER CIR",
            "address_2": "SUITE 200",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661189",
            "telephone_number": "270-251-4545",
            "fax_number": "270-251-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA FAMILY PRACTICE PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLASS",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "270-251-4545",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "38858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Ryan Lafever, MS LPCA
• David James Laframboise, P.T.
• Jessica Lamb
• Misty Lawson
• Jessica M Little, DPM
• Pooja Parshotam Makhija, M.D.
• Leticia Gail Mangrum
• Wanda Bingham Marshall, M.S.
• Christina Maria Martin
• Angie Marie Mason, D.I.

• Family Medicine Physician in Mayfield, KY
• Providers in Mayfield, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.