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Organization
LAKE HOSPITAL SYSTEM, INC.
Active
Organization
LAKE HOSPITAL SYSTEM, INC.
Active
Other names
Lake Health Physician Group Ob/Gyn
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT B TRACZ (CHIEF FINANCIAL OFFICER)
(440) 354-1642
Entity
Organization
Contact information
Practice address
9485 MENTOR AVE, SUITE 202, MENTOR, OH 44060-4597
(440) 205-5862
(440) 205-5861
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(440) 205-5862
(440) 205-5861
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
06/04/2010
Last updated
06/04/2010
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