Healthcare Provider Details

I. General information

NPI: 1174387377
Provider Name (Legal Business Name): CLINE MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 TOWN MOUNTAIN RD SUITE #100
PIKEVILLE KY
41501
US

IV. Provider business mailing address

387 TOWN MOUNTAIN RD SUITE #100
PIKEVILLE KY
41501
US

V. Phone/Fax

Practice location:
  • Phone: 606-637-2334
  • Fax: 833-941-2510
Mailing address:
  • Phone: 606-637-2334
  • Fax: 833-941-2510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW GARRETT CLINE
Title or Position: PARTNER
Credential:
Phone: 606-424-3102