Internal Medicine of Lake City , PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERNAL MEDICINE OF LAKE CITY , PA

Practice address

334 SW Commerce Dr
Suite 2
Lake City, FL 32025-1502

Phone

(386) 755-1703

Fax

(386) 755-1744

NPI assigned

Dec 5, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Patrick Birmingham

Title

Director

Phone

(615) 373-7625

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144204991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 SW COMMERCE DR",
            "address_2": "SUITE 2",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251502",
            "telephone_number": "386-755-1703",
            "fax_number": "386-755-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 SW COMMERCE DR",
            "address_2": "SUITE 2",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251502",
            "telephone_number": "386-755-1703",
            "fax_number": "386-755-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF LAKE CITY , PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BIRMINGHAM",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-373-7625",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.