Organization
LAKESIDE HEALTH CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HATCH HUBBARD PA-C (OWNER/PA-C)
(731) 924-2000
Entity
Organization
Contact information
Practice address
813 E WOOD ST, PARIS, TN 38242-4223
(731) 924-2000
(731) 653-0053
Mailing address
PO BOX 1269, PARIS, TN 38242-1269
(731) 924-2000
(731) 653-0053
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1530820
—
TN
Enumeration date
10/25/2012
Last updated
10/30/2025
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