| Specialty | Taxonomy Code | |
|---|---|---|
| * | Primary Care | 261QP2300X |
* Indicates primary specialty
| NPI Number | 1255462263 |
| Legal business name LBN |
PAYETTE LAKES MEDICAL CLINIC, PA |
| Authorized official | JACQUELINE BRUNS - (VP - PHYSICIAN SERVICES) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 03/08/2007 |
| Last updated | 03/11/2008 - About 18 years ago |
| Sole proprietor1 | Not specified |
| Identifiers |
|
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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