Organization
LAKE CITY PRIMARY CARE PLLC
Active
Other names
RICHARD A WEBBER DBA LAKE CITY PRIMARY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLEY BRAULT (OFFICE MANAGER)
(518) 561-8256
Entity
Organization
Contact information
Practice address
16 DEGRANDPRE WAY, SUITE 300, PLATTSBURGH, NY 12901-6451
(518) 561-8256
Mailing address
16 DEGRANDPRE WAY, SUITE 300, PLATTSBURGH, NY 12901-6451
(518) 561-8256
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
210018
NY
207R00000X
Internal Medicine Physician
210018
NY
Other
Enumeration date
10/31/2013
Last updated
01/17/2014
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