# LAKEVIEW MEDICAL CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeview Churchland Radiology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417267410
- **Authorized official:** MICHAEL B STOUT (CEO)
- **Authorized official phone:** (757) 539-0251

## Contact information

- **Practice address:** 4868 BRIDGE RD, SUFFOLK, VA 23435-2048
- **Practice address phone:** (757) 483-7900
- **Practice address fax:** (757) 483-7164
- **Mailing address:** 2000 MEADE PKWY, SUFFOLK, VA 23434-4259
- **Mailing address phone:** (757) 539-0251
- **Mailing address fax:** (757) 934-9497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | 215137 | VA | Yes |
| 261QR0206X | Mammography Clinic/Center | 215137 | VA | — |

## Other

- **Enumeration date:** 10/12/2010
- **Last updated:** 10/21/2010