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General NPI Number Information
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NPI Number | 1275564916
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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 | 07/05/2006
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Last Update Date | 03/23/2011
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Provider Practice Location Address
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Address Line | 1791 MESQUITE AVE
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5648
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Country | US
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Telephone | 928-855-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 1791 MESQUITE AVE
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5648
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Country | US
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Telephone | 928-855-1444
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | WILLIAM F BINDER
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Credential | MD
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Telephone | 928-855-1444
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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 | 13802
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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 | 23186
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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 | 34564
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License Number State | AZ
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Taxonomy #4
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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 #5
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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 #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2641
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License Number State | AZ
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Taxonomy #7
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 8192
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License Number State | AZ
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Taxonomy #8
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6762
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License Number State | AZ
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Taxonomy #9
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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