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General NPI Number Information
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NPI Number | 1881620094
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Entity Type | Organization
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Legal Business Name | LAKES REGION PATHOLOGY ASSOCIATES, PA
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 80 HIGHLAND ST
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City | LACONIA
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State | NH
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Zip | 03246-3235
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Country | US
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Telephone | 603-524-3211
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Fax | 603-527-2959
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Provider Business Mailing Address
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Address Line | 80 HIGHLAND ST
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City | LACONIA
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State | NH
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Zip | 03246-3235
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Country | US
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Telephone | 603-524-3211
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Fax | 603-527-2959
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MARK A T KRANC
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Credential | M.D.
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Telephone | 603-524-3211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State | NH
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