Lakeside Family Medicine

LBN: Lakeside Family Medicine
Lakeside Family Medicine is an health care organization with primary practice located at 714 Hwy 70 E , Kingston OK 73439. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Lakeside Family Medicine can be contacted via phone (580) 564-0200, or through Ahearn, Pamela via phone (580) 564-0200.

Contact Information

Primary practice address
714 Hwy 70 E Kingston OK 73439
Phone: (580) 564-0200
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ahearn, Pamela Doctor of Medicine (MD)
Phone: (580) 564-0200

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1790188639
LBN Legal business name Lakeside Family Medicine
DBA Doing business as
Authorized official Ahearn, Pamela Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 7th, 2014
Last updated Oct 7th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790188639 NPPES
Oklahoma MEDICAID 200272990A

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