# LAKE HOSPITAL SYSTEM

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

## Provider details

- **NPI number:** 1346202512
- **Authorized official:** MR. MICHAEL KITTOE (CFO)
- **Authorized official phone:** (440) 354-1952

## Contact information

- **Practice address:** 36000 EUCLID AVE, WILLOUGHBY, OH 44094-4625
- **Practice address phone:** (440) 354-1618
- **Practice address fax:** (440) 354-1848
- **Mailing address:** PO BOX 714110, COLUMBUS, OH 43271-4110
- **Mailing address phone:** (440) 274-5035
- **Mailing address fax:** (440) 716-8608

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | — |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | — |
| 282N00000X | General Acute Care Hospital | — | NULL | — |

## Other

- **Enumeration date:** 04/04/2006
- **Last updated:** 08/10/2012