Organization
LAKE HOSPITAL SYSTEM, INC.
Active
Other names
Lake Health Physician Group Painesville Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD CICERO (SR. VP, BUSINESS DEVELOPMENT)
(440) 354-1739
Entity
Organization
Contact information
Practice address
1223 MENTOR AVE, PAINESVILLE, OH 44077-1833
(440) 352-1818
(440) 352-1895
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(440) 352-1818
(440) 352-1895
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/08/2009
Last updated
04/11/2011
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