Organization
LAKESHORE CLINIC, P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERTRUDE E NIXON M.D. (PHYSICIAN/OWNER)
(334) 687-5775
Entity
Organization
Contact information
Practice address
1026 S EUFAULA AVE, EUFAULA, AL 36027-2702
(334) 687-5775
(334) 687-5095
Mailing address
1026 S EUFAULA AVE, EUFAULA, AL 36027-2702
(334) 687-5775
(334) 687-5095
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16148
AL
Other
Enumeration date
02/01/2008
Last updated
02/01/2008
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