# LAKEVIEW FAMILY HEALTH CARE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053582627
- **Authorized official:** MRS. KELLI MICHELLE WARD DO (OWNER)
- **Authorized official phone:** (928) 854-1800

## Contact information

- **Practice address:** 2090 SMOKETREE AVE N, LAKE HAVASU CITY, AZ 86403-5806
- **Practice address phone:** (928) 854-1800
- **Practice address fax:** (928) 854-1818
- **Mailing address:** 2090 SMOKETREE AVE N, LAKE HAVASU CITY, AZ 86403-5806
- **Mailing address phone:** (928) 854-1800
- **Mailing address fax:** (928) 854-1818

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 3425 | AZ | Yes |

## Other

- **Enumeration date:** 03/21/2008
- **Last updated:** 04/20/2008

## 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 |