# LAKELAND MEDICAL PRACTICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeside Urology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588941066
- **Authorized official:** WARREN WHITE JR. (VICE PRESIDENT PHYSICIAN PRACTICES)
- **Authorized official phone:** (269) 983-8304

## Contact information

- **Practice address:** 815 SAINT JOSEPH DR, SAINT JOSEPH, MI 49085-2529
- **Practice address phone:** (269) 983-3455
- **Practice address fax:** (269) 983-5920
- **Mailing address:** 815 SAINT JOSEPH DR, SAINT JOSEPH, MI 49085-2529
- **Mailing address phone:** (269) 983-3455
- **Mailing address fax:** (269) 983-5920

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 4301063125 | MI | Yes |

## Other

- **Enumeration date:** 11/10/2011
- **Last updated:** 03/14/2016