# LAKEVIEW INTERNAL MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeview Internal Medicine and Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518293323
- **Authorized official:** WILLIAM TEDRICK JOHNSON (GROUP VP/AO)
- **Authorized official phone:** (615) 372-3375

## Contact information

- **Practice address:** 444 W BOURNE CIR STE 101, FARMINGTON, UT 84025-3657
- **Practice address phone:** (801) 294-9333
- **Practice address fax:** (801) 294-7558
- **Mailing address:** 2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
- **Mailing address phone:** (615) 373-7406
- **Mailing address fax:** (866) 346-1426

## Taxonomy

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