Organization
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC.
Active
Parent organization
LAKEVIEW MEMORIAL HOSPITAL
Other names
Lakeview Hospital Physicians
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKEVIEW MEMORIAL HOSPITAL
Authorized official
DOUGLAS EDWARD JOHNSON (CFO)
(651) 430-4581
Entity
Organization
Contact information
Practice address
927 CHURCHILL ST W, STILLWATER, MN 55082-6605
(651) 430-4529
(651) 430-4528
Mailing address
PO BOX 310, STILLWATER, MN 55082-0310
(651) 430-4529
(651) 430-4528
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
363LN0000X
Neonatal Nurse Practitioner
Primary
365380
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110674
HEALTHPARTNERS
MN
01
—
300064
UCARE
MN
05
—
32889100
—
WI
01
—
3946489
MEDICA CHOICE
MN
01
—
56697TE
BLUE CROSS MN
MN
01
—
65247
PREFERRED ONE
MN
05
—
834547300
—
MN
01
—
C63317
MEDICARE RAILROAD
MN
Enumeration date
03/22/2007
Last updated
01/21/2019
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