| Lakeview Family Medicine | |
|
1316 N Lake Dr Lexington SC 29072-7653 | |
| (803) 358-1191 | |
| Not Available |
| Full Name | Lakeview Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1316 N Lake Dr, Lexington, South Carolina |
| Authorized Official Name and Position | Darrell C Coven (DIRECTOR, AMBULATORY SERVICESFINANC) |
| Authorized Official Contact | 8032967301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeview Family Medicine Po Box 402145 Atlanta GA 30384-2145 Ph: (803) 296-7305 | Lakeview Family Medicine 1316 N Lake Dr Lexington SC 29072-7653 Ph: (803) 358-1191 |
| NPI Number | 1093090482 |
|---|---|
| Provider Enumeration Date | 10/17/2011 |
| Last Update Date | 08/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093090482 | NPI | - | NPPES |
| GP5806 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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