Provider Demographics
NPI:1174387377
Name:CLINE MEDICAL GROUP LLC
Entity type:Organization
Organization Name:CLINE MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:GARRETT
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-424-3102
Mailing Address - Street 1:387 TOWN MOUNTAIN RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501
Mailing Address - Country:US
Mailing Address - Phone:606-637-2334
Mailing Address - Fax:833-941-2510
Practice Address - Street 1:387 TOWN MOUNTAIN RD
Practice Address - Street 2:SUITE #100
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501
Practice Address - Country:US
Practice Address - Phone:606-637-2334
Practice Address - Fax:833-941-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care