# LAKELAND MEDICAL PRACTICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LAKELAND MEDICAL PRACTICES
- **Other names:** Lakeland Primary Care, Royalton
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902462682
- **Legal business name:** LAKELAND MEDICAL PRACTICES
- **Authorized official:** MORGAN VINCENT (COORDINATOR)
- **Authorized official phone:** (269) 983-8282

## Contact information

- **Practice address:** 3950 HOLLYWOOD RD STE 270, SAINT JOSEPH, MI 49085-9158
- **Practice address phone:** (269) 982-7840
- **Practice address fax:** (269) 982-7843
- **Mailing address:** 3950 HOLLYWOOD RD STE 270, SAINT JOSEPH, MI 49085-9158
- **Mailing address phone:** (269) 982-7840
- **Mailing address fax:** (269) 982-7843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/17/2019
- **Last updated:** 05/17/2019