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LAKESIDE ORTHOPEDIC INSTITUTE LLC NPI 1275564916


NPI Information

NPI: 1275564916
Provider Name: LAKESIDE ORTHOPEDIC INSTITUTE LLC
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization

CLIA Number: 03D2025537

Address:
1791 MESQUITE AVE
LAKE HAVASU CITY, AZ
ZIP 86403
Phone: (928) 855-1444
Get Directions

LAKESIDE ORTHOPEDIC INSTITUTE LLC is an orthopaedic surgery in Lake Havasu City, AZ. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. LAKESIDE ORTHOPEDIC INSTITUTE LLC NPI is 1275564916. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1791 MESQUITE AVE
LAKE HAVASU CITY, AZ
ZIP 86403-648
Phone: (928) 855-1444

The provider's authorized official is William F Binder .
The authorized official title is Managing Partner and has the following contact phone number (928) 855-1444.

The CLIA number assigned to this NPI record is 03D2025537 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/5/2006 and was last updated on 3/23/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic Surgery13802ARIZONANo
2207X00000XOrthopaedic Surgery23186ARIZONANo
3207X00000XOrthopaedic Surgery34564ARIZONANo
4207X00000XOrthopaedic Surgery26379ARIZONANo
5213ES0103XPodiatristFoot & Ankle Surgery0554ARIZONANo
6225100000XPhysical Therapist2641ARIZONANo
7225100000XPhysical Therapist8192ARIZONANo
8225100000XPhysical Therapist6762ARIZONANo
9207X00000XOrthopaedic SurgeryYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DF0357OTHERARIZONAMEDICARE RAILROAD
25924960001MEDICARE NSCARIZONA
3Z110835MEDICARE PINARIZONA

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.