Organization
LAKESIDE MEMORIAL HOSPITAL INC.
Active
Other names
Lakeside Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE KINGDOLLAR (ACCOUNTS RECEIVABLE MANAGER)
(585) 395-6095
Entity
Organization
Contact information
Practice address
156 WEST AVE, BROCKPORT, NY 14420
(585) 395-6095
(585) 395-6084
Mailing address
156 WEST AVE, BROCKPORT, NY 14420
(585) 395-6095
(585) 395-6084
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/09/2007
Last updated
03/25/2011
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