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LAKEWOOD FAMILY MEDICINE PLC NPI 1073609392


NPI Information

NPI: 1073609392
Provider Name: LAKEWOOD FAMILY MEDICINE PLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 23D0379495

Address:
382 N 120TH AVE
HOLLAND, MI
ZIP 49424
Phone: (616) 396-6516
Get Directions

LAKEWOOD FAMILY MEDICINE PLC is a family medicine in Holland, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LAKEWOOD FAMILY MEDICINE PLC NPI is 1073609392. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

382 N 120TH AVE
HOLLAND, MI
ZIP 49424-169
Phone: (616) 396-6516
Fax: (616) 396-2513

The provider's authorized official is Timothy Victor Smith .
The authorized official title is Physician and has the following contact phone number (616) 396-6516.

The CLIA number assigned to this NPI record is 23D0379495 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/5/2006 and was last updated on 11/9/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1080G06011OTHERMICHIGANBCBS MI GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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