NPI Profile for LAKESIDE PEDIATRIC ADOLESCENT MEDICINE PLLC in COEUR D'ALENE, ID.
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adolescent Medicine |
2080A0000X | 37 | Physician/Pediatric Medicine |
| NPI # | 1003975087 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 12/06/2006 | |
| Last updated | 07/12/2012 - About 14 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
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| Hospital affiliation(s) | Not Available |
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LAKESIDE PEDIATRIC & ADOLESCENT MEDICINE, PLLC
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| BROOK Y LANG, MD 2003 KOOTENAI HEALTH WAY COEUR D'ALENE, ID |
| LISA L MCGILL VARGAS, MD 2003 KOOTENAI HEALTH WAY COEUR D'ALENE, ID |
| MATTHEW PARKER, MD LAKESIDE PEDIATRIC & ADOLESCENT MEDICINE COEUR D'ALENE, ID |
| BRIAN J HICKOK, MD 980 W IRONWOOD DR COEUR D'ALENE, ID |
| KENDRA M BLACK SMITH, MD 2003 KOOTENAI HEALTH WAY COEUR D'ALENE, ID |
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