| Lakeside School | |
|
360 A Hwy 82 Lake Village AR 71653 | |
| (870) 201-2127 | |
| (888) 671-8943 |
| Full Name | Lakeside School |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 360 A Hwy 82, Lake Village, Arkansas |
| Authorized Official Name and Position | Gary Allan Nichols (CEO) |
| Authorized Official Contact | 8709423000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside School Po Box 509 Dermott AR 71638-0509 Ph: (870) 942-3000 | Lakeside School 360 A Hwy 82 Lake Village AR 71653 Ph: (870) 201-2127 |
| NPI Number | 1326586173 |
|---|---|
| Provider Enumeration Date | 02/01/2017 |
| Last Update Date | 07/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326586173 | NPI | - | NPPES |
| 226028631 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Chicot Memorial Medical Center Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2729 S. Hwy 65 82, Lake Village, AR 71653 Phone: 870-265-5351 |