Lake Country Physicians

LBN: Lake Country Pediatrics Sc
Lake Country Physicians is an health care organization with primary practice located at 970 S Silver Lake St Ste. 102, Oconomowoc WI 53066-3802. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Lake Country Pediatrics Sc can be contacted via phone (262) 569-7100, or through Moyer, Gregory M via phone (262) 569-7100.

Contact Information

Primary practice address
970 S Silver Lake St Ste. 102 Oconomowoc WI 53066-3802
Phone: (262) 569-7100
Fax: (262) 567-6295
Website:
Map and Directions
Authorized official contact:
Name: Moyer, Gregory M Doctor of Medicine (MD)
Phone: (262) 569-7100

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35710 Wisconsin

Profile Details

NPI number 1801849963
LBN Legal business name Lake Country Pediatrics Sc
DBA Doing business as Lake Country Physicians
Authorized official Moyer, Gregory M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 18th, 2006
Last updated Aug 15th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801849963 NPPES
Wisconsin MEDICAID 21250600

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