# LAKELAND PHYSICIAN CARE NETWORK

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FOUR FLAGS HEALTH VENTURES
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1194992784
- **Legal business name:** FOUR FLAGS HEALTH VENTURES
- **Authorized official:** DENNIS MACK (V.P. OPERATIONS & FACILITY MANAGEME)
- **Authorized official phone:** (269) 983-8399

## Contact information

- **Practice address:** 1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
- **Practice address phone:** (269) 684-0259
- **Practice address fax:** (269) 684-0189
- **Mailing address:** PO BOX 458, NILES, MI 49120-0458
- **Mailing address phone:** (269) 684-0259
- **Mailing address fax:** (269) 684-0189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/13/2008
- **Last updated:** 05/13/2008