| Lake Park Family Practice | |
|
6208 Creft Cir Ste 222 Indian Trail NC 28079-9003 | |
| (980) 993-7150 | |
| Not Available |
| Full Name | Lake Park Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 6208 Creft Cir, Indian Trail, North Carolina |
| Authorized Official Name and Position | Scott Rissmiller (ENTERPRISE EVP) |
| Authorized Official Contact | 7043558675 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Park Family Practice Po Box 19305 Charlotte NC 28219-9305 Ph: (704) 631-0002 | Lake Park Family Practice 6208 Creft Cir Ste 222 Indian Trail NC 28079-9003 Ph: (980) 993-7150 |
| NPI Number | 1568717478 |
|---|---|
| Provider Enumeration Date | 07/17/2012 |
| Last Update Date | 03/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568717478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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