Lakeland Primary Care Clinic | |
1040 River Oaks Dr Flowood MS 39232-9530 | |
(601) 664-9299 | |
(601) 664-9267 |
Full Name | Lakeland Primary Care Clinic |
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Speciality | Family Medicine |
Location | 1040 River Oaks Dr, Flowood, Mississippi |
Authorized Official Name and Position | T. Emile Lagarde (OWNER) |
Authorized Official Contact | 6016649299 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lakeland Primary Care Clinic Po Box 321016 Flowood MS 39232-1016 Ph: (601) 664-9299 | Lakeland Primary Care Clinic 1040 River Oaks Dr Flowood MS 39232-9530 Ph: (601) 664-9299 |
NPI Number | 1235236340 |
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Provider Enumeration Date | 09/20/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 3072569698 |
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Medicare Enrollment ID | O20050328000385 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235236340 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Thomas E Lagarde |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922049238 PECOS PAC ID: 0345296968 Enrollment ID: I20050331000502 |
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