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Contact Information

LAKE FAMILY VISION CENTER INC
138 SOUTH MAIN
SUITE C
LAURIE, MO65038-1185
 Phone: 573-374-5222
 Fax: 573-374-7351
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for LAKE FAMILY VISION CENTER INC

NPI Number 1720128713
LBN Legal business name LAKE FAMILY VISION CENTER INC
Authorized official WILLIAM SCOGGIN - (OPTOMETRIST OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/07/2007
Last updated 12/21/2007 - About 18 years ago
Identifiers
MO License # T02682
MO Other 0323200001 CIGNA MEDICARE
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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