Organization
LAKE COUNTY MEDICAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEENA M FELDER (OFFICE MANAGER)
(541) 947-3366
Entity
Organization
Contact information
Practice address
624 S J ST, LAKEVIEW, OR 97630-1680
(541) 947-3366
(541) 947-4404
Mailing address
624 S J ST, LAKEVIEW, OR 97630-1680
(541) 947-3366
(541) 947-4404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246694
—
OR
Enumeration date
12/23/2005
Last updated
07/02/2010
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