| Lakeside Clinic Llc | |
|
2337 Homer Clayton Drive Guntersville AL 35976 | |
| (256) 582-5131 | |
| (256) 582-1100 |
| Full Name | Lakeside Clinic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2337 Homer Clayton Drive, Guntersville, Alabama |
| Authorized Official Name and Position | Carolyn H Masor (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 2565825131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Clinic Llc 2337 Homer Clayton Drive Guntersville AL 35976 Ph: (256) 582-5131 | Lakeside Clinic Llc 2337 Homer Clayton Drive Guntersville AL 35976 Ph: (256) 582-5131 |
| NPI Number | 1477657823 |
|---|---|
| Provider Enumeration Date | 09/07/2006 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 8628980034 |
|---|---|
| Medicare Enrollment ID | O20031104000389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477657823 | NPI | - | NPPES |
| 22839 | Other | NIXON AL LIC NUMBER | |
| 9801 | Other | BOGGESS AL LIC NUMBER | |
| 10014 | Other | LARSON AL LIC NUMBER | |
| 25574 | Other | FOLEY AL LIC NUMBER | |
| 23185 | Other | REED-JOHNSON AL LIC NUMB |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | John W Boggess |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699731935 PECOS PAC ID: 3779559927 Enrollment ID: I20040908001378 |
| Provider Name | William A Nixon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699731927 PECOS PAC ID: 6507832771 Enrollment ID: I20040908001511 |
| Provider Name | Jeffrey M Saylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174589410 PECOS PAC ID: 3274509336 Enrollment ID: I20040909000509 |
| Provider Name | Joel C Milligan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093829640 PECOS PAC ID: 9931190113 Enrollment ID: I20100616000766 |
| Provider Name | Joshua D Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548599798 PECOS PAC ID: 7810185535 Enrollment ID: I20101222000601 |
| Provider Name | Amanda Noel Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265893952 PECOS PAC ID: 7618276197 Enrollment ID: I20160504002748 |
| Provider Name | Morgan Chatham Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801272638 PECOS PAC ID: 9638452147 Enrollment ID: I20180726001128 |
| Provider Name | Embril Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982101846 PECOS PAC ID: 5698178119 Enrollment ID: I20210721003179 |
| Provider Name | Haley Virginia Gates |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912403247 PECOS PAC ID: 0446655153 Enrollment ID: I20210818002718 |
| Provider Name | Stephanie Mashae Beaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952052631 PECOS PAC ID: 6305239468 Enrollment ID: I20220214000536 |
Marshall Medical Center North Jones Pediatric Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 Medical Park Dr, B, Guntersville, AL 35976 Phone: 256-571-8969 Fax: 256-571-8980 | |
Lakeside North Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 38 Rowe Dr, Guntersville, AL 35976 Phone: 256-571-8460 Fax: 256-571-8464 | |
Marshall Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7938 Alabama Hwy 69, Ste 350, Guntersville, AL 35976 Phone: 256-571-8500 Fax: 256-571-8502 | |
Marshall Medical Center North Family Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7938 Al Highway 69, Suite 360, Guntersville, AL 35976 Phone: 256-571-8580 Fax: 256-571-8585 | |
Lakeside North Family Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 38 Rowe Dr, Guntersville, AL 35976 Phone: 256-571-8460 Fax: 256-571-8464 | |
Grant Family Practice Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1241 Blount Ave, Guntersville, AL 35976 Phone: 256-582-6377 Fax: 256-582-6376 | |
Lakeside North, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7938 Al Highway 69, Suite 130, Guntersville, AL 35976 Phone: 256-571-8460 Fax: 256-571-8464 |