# LAKE CITY PRIMARY CARE PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake City Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952896151
- **Authorized official:** JASON BALL (OFFICE MANAGER)
- **Authorized official phone:** (231) 908-8888

## Contact information

- **Practice address:** 1866 S MOREY RD, LAKE CITY, MI 49651
- **Practice address phone:** (231) 908-8888
- **Practice address fax:** (833) 989-2153
- **Mailing address:** 1866 S MOREY RD, LAKE CITY, MI 49651-9190
- **Mailing address phone:** (231) 830-7282
- **Mailing address fax:** (231) 830-7222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/29/2018
- **Last updated:** 10/03/2022