Organization
LAKE HOSPITAL SYSTEM, INC.
Active
Other names
Lake Health Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT TRACZ (CHIEF FINANCIAL OFFICER)
(440) 354-1642
Entity
Organization
Contact information
Practice address
36060 EUCLID AVE, SUITE 203, WILLOUGHBY, OH 44094-4656
(440) 602-6670
(440) 602-6671
Mailing address
P.O. BOX 714328, COLUMBUS, OH 43271-4328
(440) 602-6670
(440) 602-6671
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
12/19/2007
Last updated
04/14/2011
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