Lakeshore Clinic, P C

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16148 Issued in AL

Legal business name

LAKESHORE CLINIC, P C

Practice address

1026 S Eufaula Ave
Eufaula, AL 36027-2702

Phone

(334) 687-5775

Fax

(334) 687-5095

NPI assigned

Feb 1, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Gertrude E Nixon, M.D.

Title

Physician/Owner

Phone

(334) 687-5775

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1346428331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 S EUFAULA AVE",
            "city": "EUFAULA",
            "state": "AL",
            "postal_code": "360272702",
            "telephone_number": "334-687-5775",
            "fax_number": "334-687-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 S EUFAULA AVE",
            "city": "EUFAULA",
            "state": "AL",
            "postal_code": "360272702",
            "telephone_number": "334-687-5775",
            "fax_number": "334-687-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE CLINIC, P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "GERTRUDE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "334-687-5775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "16148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Eufaula, AL
• Providers in Eufaula, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.