Organization
LAKESIDE FAMILY HEALTH CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ROBERTSON MD (OWNER)
(928) 537-4379
Entity
Organization
Contact information
Practice address
5658 HIGHWAY 260, SUITE 24, LAKESIDE, AZ 85929-5189
(928) 537-4379
(928) 537-4653
Mailing address
5658 HIGHWAY 260 STE 24, LAKESIDE, AZ 85929-5189
(928) 537-4379
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
01/30/2006
Last updated
01/26/2015
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