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Contact Information

LAKESIDE ORTHOPEDIC INSTITUTE, LLC
150 EAST TYSON RD
QUARTZSITE, AZ85359
 Phone: 928-505-5555
 Fax: 928-505-2877
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for LAKESIDE ORTHOPEDIC INSTITUTE LLC · (Female)

NPI Number 1902137417
Status Active
Credentials
Entity Individual
Enumeration date 01/22/2010
Last updated 02/17/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • AZ License # 0554
  • AZ License # 13802
  • AZ License # 23186
  • AZ License # 26379
  • AZ License # 34564
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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