Organization
LAKE CITY PRIMARY CARE PC
Active
Other names
Lake City Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BALL (OFFICE MANAGER)
(231) 908-8888
Entity
Organization
Contact information
Practice address
1866 S MOREY RD, LAKE CITY, MI 49651
(231) 908-8888
(833) 989-2153
Mailing address
1866 S MOREY RD, LAKE CITY, MI 49651-9190
(231) 830-7282
(231) 830-7222
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
238938
—
MI
05
—
MI12315
—
MI
Enumeration date
06/29/2018
Last updated
10/03/2022
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