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General NPI Number Information
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NPI Number | 1023349511
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Entity Type | Organization
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Legal Business Name | LAKESIDE ORTHOPEDIC INSTITUTE, LLC
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 1016 S JOSHUA AVE.
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City | PARKER
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State | AZ
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Zip | 85344-5027
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Country | US
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Telephone | 928-505-5555
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Fax | 928-505-2877
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Provider Business Mailing Address
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Address Line | 25 RIVIERA BLVD
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5694
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Country | US
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Telephone | 928-505-5555
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Fax | 928-505-2877
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Authorized Official
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Title or Position | PARTNER/PRESIDENT
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Name | WILLIAM F. BINDER
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Credential | M.D.
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Telephone | 928-505-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 23186
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 34564
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 26379
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0554
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 13802
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License Number State | AZ
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