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Organization
LAKEVIEW FAMILY HEALTH CARE
Active
Organization
LAKEVIEW FAMILY HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLI MICHELLE WARD DO (OWNER)
(928) 854-1800
Entity
Organization
Contact information
Practice address
2090 SMOKETREE AVE N, LAKE HAVASU CITY, AZ 86403-5806
(928) 854-1800
(928) 854-1818
Mailing address
2090 SMOKETREE AVE N, LAKE HAVASU CITY, AZ 86403-5806
(928) 854-1800
(928) 854-1818
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3425
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470724
—
AZ
01
—
AZ0857940
BLUE CROSS BLUE SHIELD AZ
AZ
01
—
CG1872
RAILROAD MEDICARE
AZ
01
—
G96720
MEDICARE GROUP
AZ
Enumeration date
03/21/2008
Last updated
04/20/2008
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