| Lakewood Health Center | |
|
600 Main Ave S Baudette MN 56623-2855 | |
| (218) 634-1655 | |
| (218) 634-1094 |
| Full Name | Lakewood Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 Main Ave S, Baudette, Minnesota |
| Authorized Official Name and Position | Jeffry A Stampohar (PRESIDENT) |
| Authorized Official Contact | 2186342120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Health Center 600 Main Ave S Baudette MN 56623-2855 Ph: (218) 634-1655 | Lakewood Health Center 600 Main Ave S Baudette MN 56623-2855 Ph: (218) 634-1655 |
| NPI Number | 1972799237 |
|---|---|
| Provider Enumeration Date | 09/20/2007 |
| Last Update Date | 02/27/2020 |
| Medicare PECOS PAC ID | 5698687929 |
|---|---|
| Medicare Enrollment ID | O20031104000469 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972799237 | NPI | - | NPPES |
| 199245700 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Daniel Joseph Margo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083727200 PECOS PAC ID: 2860398187 Enrollment ID: I20031209000272 |
| Provider Name | Courtney Whitney |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1861461329 PECOS PAC ID: 9739087826 Enrollment ID: I20031230000235 |
| Provider Name | Jerry R Bartleson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386686376 PECOS PAC ID: 0042102667 Enrollment ID: I20040625000032 |
| Provider Name | Bruce M Dahlman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922058866 PECOS PAC ID: 3678559986 Enrollment ID: I20040628000518 |
| Provider Name | David Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275629719 PECOS PAC ID: 0648241232 Enrollment ID: I20040805000876 |
| Provider Name | Daniel S Vechell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275634628 PECOS PAC ID: 8426005414 Enrollment ID: I20050401000291 |
| Provider Name | Fritz Leidig |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871533851 PECOS PAC ID: 7113916305 Enrollment ID: I20050602000726 |
| Provider Name | Justin Quo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285947556 PECOS PAC ID: 9931342714 Enrollment ID: I20130826001067 |
| Provider Name | Fahd Arafat |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538423637 PECOS PAC ID: 9436371556 Enrollment ID: I20141105000986 |
| Provider Name | Adriana Andrea Escandon Sandino |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1942327689 PECOS PAC ID: 5092996686 Enrollment ID: I20170315000256 |
| Provider Name | Dawn Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124557103 PECOS PAC ID: 5294006581 Enrollment ID: I20170804000796 |
| Provider Name | Jordan Reese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194215830 PECOS PAC ID: 5092066654 Enrollment ID: I20180920000676 |
| Provider Name | Scott Harris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740402858 PECOS PAC ID: 5890835334 Enrollment ID: I20190805002641 |
| Provider Name | Michelle Renee Lanning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144876103 PECOS PAC ID: 6709115165 Enrollment ID: I20190910001928 |
| Provider Name | Sarah J Gubbels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043532252 PECOS PAC ID: 2062701329 Enrollment ID: I20211220002349 |
| Provider Name | Sheila D Bullock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366943334 PECOS PAC ID: 8729342381 Enrollment ID: I20220422000536 |
| Provider Name | Gina Ann Lablanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669198040 PECOS PAC ID: 3779952395 Enrollment ID: I20221202002647 |
| Provider Name | Sharon Falke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578591947 PECOS PAC ID: 8527024264 Enrollment ID: I20231024003575 |
| Provider Name | Morgan M Longtin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962260851 PECOS PAC ID: 5193163186 Enrollment ID: I20240410001372 |
Lakewood Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 600 Main Ave S, Baudette, MN 56623 Phone: 218-634-1655 Fax: 218-634-1094 |