Organization
LAKESIDE ORTHOPEDIC INSTITUTE, LLC
Active
Organization
LAKESIDE ORTHOPEDIC INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM F. BINDER M.D. (PARTNER/PRESIDENT)
(928) 505-5555
Entity
Organization
Contact information
Practice address
1016 S JOSHUA AVE., PARKER, AZ 85344-5027
(928) 505-5555
(928) 505-2877
Mailing address
25 RIVIERA BLVD, LAKE HAVASU CITY, AZ 86403-5694
(928) 505-5555
(928) 505-2877
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
13802
AZ
207X00000X
Orthopaedic Surgery Physician
23186
AZ
207X00000X
Orthopaedic Surgery Physician
26379
AZ
207X00000X
Orthopaedic Surgery Physician
34564
AZ
213ES0103X
Foot & Ankle Surgery Podiatrist
0554
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5924960004
DMERC PTAN
AZ
Enumeration date
01/22/2010
Last updated
04/21/2011
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