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Contact Information

LAKESIDE INTEGRATED GROUP, LLC
1864 THOMPSON BRIDGE ROAD
GAINESVILLE, GA30501
 Phone: 770-538-0330
 Fax: 770-535-0643
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for LAKESIDE INTEGRATED GROUP, LLC

NPI # 1336516947
LBN Legal business name LAKESIDE INTEGRATED GROUP, LLC
Authorized official WILLIAM CREWS - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/31/2015
Last updated 08/31/2015 - About 11 years ago
Identifiers
GA License # 5133
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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