LAKESIDE INTEGRATED GROUP LLC NPI 1336516947

NPI Information

  • NPI: 1336516947
  • Provider Name: LAKESIDE INTEGRATED GROUP, LLC
  • Classification: Chiropractor - 111N00000X
  • Entity Type: Organization
  • Address: 1864 THOMPSON BRIDGE ROAD
    GAINESVILLE, GA
    ZIP 30501
  • Phone: (770) 538-0330

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NPI Details

LAKESIDE INTEGRATED GROUP, LLC is a chiropractor in Gainesville, GA. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. LAKESIDE INTEGRATED GROUP, LLC NPI is 1336516947. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1864 THOMPSON BRIDGE ROAD
GAINESVILLE, GA
ZIP 30501
Phone: (770) 538-0330
Fax: (770) 535-0643

The provider's authorized official is William Terry Crews .
The authorized official title is President and has the following contact phone number (770) 538-0330.

The enumeration date for this NPI number is 8/31/2015 and was last updated on 8/31/2015.

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
1111N00000XChiropractor5133GEORGIAYes

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
135ZCCSPMEDICARE UPINGEORGIA

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: 11/21/2025

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