Organization
LAKELAND MEDICAL PRACTICES
Active
Other names
Southwest Medical Clinic Buchanan
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN WHITE JR. (VICE PRESIDENT PHYSICIAN PRACTICES)
(269) 983-8172
Entity
Organization
Contact information
Practice address
1045 E FRONT ST, SUITE A, BUCHANAN, MI 49107-8474
(269) 695-5540
(269) 428-5507
Mailing address
1045 E FRONT ST, SUITE A, BUCHANAN, MI 49107-8474
(269) 695-5540
(269) 428-5507
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301093962
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538397120
—
MI
Enumeration date
09/27/2016
Last updated
09/27/2016
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