Organization
LAKE REGIONAL HEALTH SYSTEM
Active
Other names
Lake Regional Foot & Ankle Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA SUE LITTLETON (CFO)
(573) 348-8388
Entity
Organization
Contact information
Practice address
1075 NICHOLS RD, SUITE 1-2, OSAGE BEACH, MO 65065-3093
(573) 302-2828
(573) 302-2830
Mailing address
PO BOX 801661, KANSAS CITY, MO 64180-1661
(573) 348-8000
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3928520002
DME PTAN
MO
05
—
501945604
—
MO
Enumeration date
09/09/2011
Last updated
05/23/2025
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