Lakeside Family Medicine

LBN: Lakeside Family Medicine
Lakeside Family Medicine is an health care organization with primary practice located at 21 N. Main Street , Kingston OK 73439-1798. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Lakeside Family Medicine can be contacted via phone (580) 226-1010, or through Ahearn, Pamela E via phone (580) 226-1010.

Contact Information

Primary practice address
21 N. Main Street Kingston OK 73439-1798
Phone: (580) 226-1010
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ahearn, Pamela E Doctor of Medicine (MD)
Phone: (580) 226-1010

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 19862 Oklahoma

Profile Details

NPI number 1295064178
LBN Legal business name Lakeside Family Medicine
DBA Doing business as
Authorized official Ahearn, Pamela E Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 23rd, 2009
Last updated Dec 23rd, 2009 - about 15 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 1295064178 NPPES
Oklahoma MEDICAID PENDING

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