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General NPI Number Information
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NPI Number | 1013327527
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Entity Type | Organization
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Legal Business Name | COMMUNITY URGENT CARE LAKESIDE NORTH
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Dates
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Enumeration Date | 05/06/2014
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 38 ROWE DR
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-7367
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Country | US
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Telephone | 256-571-8460
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Fax | 256-571-8464
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Provider Business Mailing Address
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Address Line | 38 ROWE DR
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-7367
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Country | US
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Telephone | 256-571-8460
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Fax | 256-571-8464
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | NAKITA MEREDITH
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Credential |
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Telephone | 256-571-8581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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