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Organization
LAKELAND MEDICAL PRACTICES
Active
Organization
LAKELAND MEDICAL PRACTICES
Active
Other names
Lakeside Urology
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN WHITE JR. (VICE PRESIDENT PHYSICIAN PRACTICES)
(269) 983-8304
Entity
Organization
Contact information
Practice address
815 SAINT JOSEPH DR, SAINT JOSEPH, MI 49085-2529
(269) 983-3455
(269) 983-5920
Mailing address
815 SAINT JOSEPH DR, SAINT JOSEPH, MI 49085-2529
(269) 983-3455
(269) 983-5920
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301063125
MI
Other
Enumeration date
11/10/2011
Last updated
03/14/2016
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