LAKELAND MEDICAL PRACTICES NPI 1932493863

NPI Information

  • NPI: 1932493863
  • Provider Name: LAKELAND MEDICAL PRACTICES
  • Classification: Urology - 208800000X
  • Entity Type: Organization
  • Doing Business As: LAKESIDE UROLOGY
  • Address: 42 N SAINT JOSEPH AVE
    SUITE 200
    NILES, MI
    ZIP 49120
  • Phone: (269) 684-5447

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NPI Details

LAKELAND MEDICAL PRACTICES is an urology in Niles, MI. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. LAKELAND MEDICAL PRACTICES NPI is 1932493863. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lakeside Urology.

The provider's business location address is:

42 N SAINT JOSEPH AVE
SUITE 200
NILES, MI
ZIP 49120-208
Phone: (269) 684-5447
Fax: (269) 684-0256

The provider's authorized official is Jancie Crocker .
The authorized official title is Director, Practice Operations and has the following contact phone number (268) 687-1152.

The enumeration date for this NPI number is 6/8/2011 and was last updated on 7/13/2012.

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
1208800000XUrology4301036136MICHIGANYes

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
1=========OTHERMICHIGANGROUP TAX ID
2MI2051OTHERMICHIGANGROUP MEDICARE #
31538397120OTHERMICHIGANGROUP NPI

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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