| The Lakeside Clinic | |
|
38843 Dexter Rd Dexter OR 97431-9775 | |
| (541) 937-2134 | |
| (541) 937-1370 |
| Full Name | The Lakeside Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 38843 Dexter Rd, Dexter, Oregon |
| Authorized Official Name and Position | Jayne Culberson (CFO) |
| Authorized Official Contact | 5419372134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Lakeside Clinic Po Box 110 38843 Dexter Road Dexter OR 97431-0110 Ph: (541) 937-2134 | The Lakeside Clinic 38843 Dexter Rd Dexter OR 97431-9775 Ph: (541) 937-2134 |
| NPI Number | 1710923651 |
|---|---|
| Provider Enumeration Date | 06/21/2006 |
| Last Update Date | 12/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710923651 | NPI | - | NPPES |
| 122416 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 084054259N1 (Oregon) | Primary |
Cottage Grove Community Medical Ct Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 38843 Dexter Rd, Dexter, OR 97431 Phone: 541-767-5200 | |
Peacehealth Medical Group-dexter Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 38843 Dexter Rd, Dexter, OR 97431 Phone: 541-937-2134 |