LAKESIDE SURGERY CENTER, LLC – NPI #1396634820
Clinic/Center

LAKESIDE SURGERY CENTER, LLC is an AHC clinic located in SPRINGDALE, AR. NPPES has assigned the NPI number 1396634820 to LAKESIDE SURGERY CENTER, LLC on June 30, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LAKESIDE SURGERY CENTER, LLC below.

NPI Profile for
LAKESIDE SURGERY CENTER, LLC

NPI Number
1396634820
Enumeration Date

(about a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LAKESIDE SURGERY CENTER, LLC
Primary location
6845 ISAACS ORCHARD RD
SPRINGDALE, AR 72762
Phone: (473) 236-2766 Fax:
Mailing address
741 E VAN ASCHE DR
FAYETTEVILLE, AR 72703-4916
Phone: (473) 442-5227 Fax: (472) 582-4952
Organization Subpart
No
Authorized Official
PETER DAUT
MEDICAL DIRECTOR
Phone: (479) 442-5227
Updated
Certification Date
Jun 10, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.