Lakeside Medical is a
General Practice based in Salt Lake City, Utah. Lakeside Medical is licensed to practice in Utah (license number 151129-1205) and their current practice location is
4701 W 2100 S, Building 3, Salt Lake City, Utah. It can be reached at their office (for appointments etc.) via phone at
(801) 974-3382.
NPI number for Lakeside Medical is 1528204922 and their current mailing address is 4701 W 2100 S, Building 3, Salt Lake City, Utah. Lakeside Medical
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1528204922.
Healthcare Provider's Profile
Full Name | Lakeside Medical |
---|
Type | Facility |
---|
Speciality | General Practice |
---|
Location | 4701 W 2100 S, Salt Lake City, Utah |
---|
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1528204922
- Provider Enumeration Date: 01/06/2009
- Last Update Date: 01/07/2009
Medical Identifiers
Medical identifiers for Lakeside Medical such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1528204922 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
111N00000X | Chiropractor | 6787397-1202 (Utah) | Secondary |
208D00000X | General Practice | 151129-1205 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lakeside Medical is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Lakeside Medical 4701 W 2100 S, Building 3, Salt Lake City, UT 84120-1223 Ph: (801) 974-3382 | Lakeside Medical 4701 W 2100 S, Building 3, Salt Lake City, UT 84120-1223 Ph: (801) 974-3382 |
Reviews and Comments