| Lake Erie College Of Osteopathic Medicine | |
|
101 Lecom Way Defuniak Springs FL 32435-6323 | |
| (850) 951-0200 | |
| Not Available |
| Full Name | Lake Erie College Of Osteopathic Medicine |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 101 Lecom Way, Defuniak Springs, Florida |
| Authorized Official Name and Position | Steven Gregory Inman (VP FISCAL AFFAIRS/CFO) |
| Authorized Official Contact | 8148688258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Erie College Of Osteopathic Medicine 1858 W Grandview Blvd Erie PA 16509-1025 Ph: (814) 868-7767 | Lake Erie College Of Osteopathic Medicine 101 Lecom Way Defuniak Springs FL 32435-6323 Ph: (850) 951-0200 |
| NPI Number | 1710422670 |
|---|---|
| Provider Enumeration Date | 01/03/2017 |
| Last Update Date | 05/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710422670 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (Florida) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Defuniak Springs Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 746 Baldwin Avenue, Defuniak Springs, FL 32435 Phone: 850-892-0866 Fax: 850-892-4280 |