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Organization

LAKELAND MEDICAL PRACTICES

Active
Other names
Lakeside Urology
Organization subpart
No

Provider details

NPI number
Authorized official
WARREN WHITE JR. (VICE PRESIDENT PHYSICIAN PRACTICES)
(269) 983-8304
Entity
Organization

Contact information

Practice address
815 SAINT JOSEPH DR, SAINT JOSEPH, MI 49085-2529
(269) 983-3455
(269) 983-5920
Mailing address
815 SAINT JOSEPH DR, SAINT JOSEPH, MI 49085-2529
(269) 983-3455
(269) 983-5920

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301063125
MI

Other

Enumeration date
11/10/2011
Last updated
03/14/2016
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