# LAKESIDE OBSTETRICS & GYNECOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699933838
- **Authorized official:** DR. KEVIN JAMES HOOKER MD (CO MANAGER)
- **Authorized official phone:** (573) 302-1114

## Contact information

- **Practice address:** 980 PARKSIDE VILLAGE LN, OSAGE BEACH, MO 65065-3098
- **Practice address phone:** (573) 302-1114
- **Practice address fax:** (573) 302-0077
- **Mailing address:** 980 PARKSIDE VILLAGE LN, OSAGE BEACH, MO 65065-3098
- **Mailing address phone:** (573) 302-1114
- **Mailing address fax:** (573) 302-0077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 2008006546 | MO | Yes |

## Other

- **Enumeration date:** 05/23/2008
- **Last updated:** 11/10/2008