# LAKE COUNTY MEDICAL CLINIC, P.C.

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

## Provider details

- **NPI number:** 1922085604
- **Authorized official:** MRS. SHEENA M FELDER (OFFICE MANAGER)
- **Authorized official phone:** (541) 947-3366

## Contact information

- **Practice address:** 624 S J ST, LAKEVIEW, OR 97630-1680
- **Practice address phone:** (541) 947-3366
- **Practice address fax:** (541) 947-4404
- **Mailing address:** 624 S J ST, LAKEVIEW, OR 97630-1680
- **Mailing address phone:** (541) 947-3366
- **Mailing address fax:** (541) 947-4404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | OR | Yes |

## Other

- **Enumeration date:** 12/23/2005
- **Last updated:** 07/02/2010