Lake County Medical Clinic, P.C.
Organization Active NPI Family Medicine Physician · Lakeview, OR
NPI 1922085604 · NPPES record last updated Jul 2, 2010
Key facts
- NPI
- 1922085604
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- LAKE COUNTY MEDICAL CLINIC, P.C.
- Practice address
- 624 S J St
Lakeview, OR 97630-1680 - Phone
- (541) 947-3366
- Fax
- (541) 947-4404
- NPI assigned
- Dec 23, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Sheena M Felder
- Title
- Office Manager
- Phone
- (541) 947-3366
Practitioners 5
-
Robert W Bomengen, M.D.
-
Rosanne Fitzgerald, FNP-BC
-
Stephen A Hussey, M.D.
-
Kathleen J. Thompson, PA-C
National Provider Directory
Locations
624 S J St
Lakeview, OR 97630
Phone (541) 947-3366
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | OR | Yes |
Addresses
Primary practice location
624 S J St
Lakeview, OR 97630-1680
Mailing address
624 S J St
Lakeview, OR 97630-1680
Phone (541) 947-3366
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 246694 | Medicaid | OR |
Other providers in Lakeview, OR
- Kindred Heritage DME LLC
- Klamath Ophthalmology, PC
- Megan Kruse
- Darrel Kyniston Kyniston
- Lake County Esd
- Lake County Mental Health
- Lake County Mental Health
- Lake County School District #7
- Lake District Health
- Lake District Hospital Physicians Group
All providers in Lakeview, OR · Family Medicine Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.