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Organization
LAKEVIEW INTERNAL MEDICINE, LLC
Active
Organization
LAKEVIEW INTERNAL MEDICINE, LLC
Active
Other names
Lakeview Internal Medicine and Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM TEDRICK JOHNSON (GROUP VP/AO)
(615) 372-3375
Entity
Organization
Contact information
Practice address
444 W BOURNE CIR STE 101, FARMINGTON, UT 84025-3657
(801) 294-9333
(801) 294-7558
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
(615) 373-7406
(866) 346-1426
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
NULL
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
10/29/2009
Last updated
08/29/2023
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