LAKESIDE HEALTH CLINIC, P.C.; NPI #1336492495

Contact Information

LAKESIDE HEALTH CLINIC, P.C.

813 E WOOD ST
PARIS, TN 38242-4223

Phone: 731-924-2000
Fax: 731-653-0053
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Rural Health	261QR1300X	B4[14]	Rural Health Clinic
General Practice	208D00000X	99	Physician/Undefined Physician type[6]

Indicates primary specialty

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NPI Profile & details for LAKESIDE HEALTH CLINIC, P.C.

NPI # 1336492495

LBN Legal business name LAKESIDE HEALTH CLINIC, P.C.

Authorized official LISA HUBBARD - (OWNER/PA-C)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/25/2012

Last updated 10/30/2025 - About 7 months ago

Identifiers

Medicaid

1530820

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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