LAKEHSORE OTOLARYNGOLOGY – NPI #1770696379
Otolaryngology

An otolaryngologist who specializes in facial plastic surgery.

Health Care Provider Taxonomy Code for Otolaryngology

LAKEHSORE OTOLARYNGOLOGY is an otolaryngologist located in HOLLAND, MI. NPPES has assigned the NPI number 1770696379 to LAKEHSORE OTOLARYNGOLOGY on August 16, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207YS0123X from the Health Care Provider Taxonomy code set, which is classified as Otolaryngology, specializing in Facial Plastic Surgery

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. 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 LAKEHSORE OTOLARYNGOLOGY below.

NPI Profile for
LAKEHSORE OTOLARYNGOLOGY

NPI Number
1770696379
Enumeration Date

(about 20 years 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
LAKEHSORE OTOLARYNGOLOGY
Primary location
577 MICHIGAN AVENUE
SUITE 101
HOLLAND, MI 49423
Phone: (616) 393-2190 Fax: (616) 393-0147
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
THEODORE VANDERVEEN
PRESIDENT
Phone: (616) 393-2190
Updated
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
207YS0123X
- Otolaryngology / Facial Plastic Surgery (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.