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NPI Code Detail

MEDICARE: LAKELAND MEDICAL PRACTICES

MEDICARE: LAKELAND MEDICAL PRACTICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1124346515
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKELAND MEDICAL PRACTICES
Provider Business Mailing Address
First Line : 5675 FAIRVIEW ST
Second Line :
City : STEVENSVILLE
State : MI
Zip : 49127-1033
Country : US
Telephone Number : 269-429-7227
Fax Number : 269-429-5754
Provider Business Practice Location Address
First Line : 5675 FAIRVIEW ST
Second Line :
City : STEVENSVILLE
State : MI
Zip : 49127-1033
Country : US
Telephone Number : 269-429-7227
Fax Number : 269-429-5754
Authorized Official
Title or Position : VP PHYSICIANS PRACTICES
Name : WARREN WHITE JR.
Credential :
Telephone Number : 269-983-8304
Provider Enumeration Date : 05/10/2010
Last Update Date : 03/14/2016

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Directions to “LAKELAND MEDICAL PRACTICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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