Organization
LAKEVIEW UROLOGY & GENERAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS JOSEPH (VP)
(615) 373-7630
Entity
Organization
Contact information
Practice address
620 EAST MEDICAL DR, SUITE 300, BOUNTIFUL, UT 84010-5171
(801) 298-3247
(801) 298-9675
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
(615) 373-7406
(866) 346-1426
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518109032
—
UT
Enumeration date
03/30/2009
Last updated
08/29/2023
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