Organization
LAKE SHORE HMA MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P WRIGHT (VP PHYSICIAN BUSINESS SERVICES)
(615) 778-1502
Entity
Organization
Contact information
Practice address
348 NE METHODIST TER STE 104, LAKE CITY, FL 32055-3408
(386) 292-8024
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
05/27/2010
Last updated
05/15/2019
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