LAKE HEALTH PHYSICIAN GROUP VASCULAR ACCESS SURGERY – NPI #1124255278
Surgery

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Health Care Provider Taxonomy Code for Surgery

LAKE HEALTH PHYSICIAN GROUP VASCULAR ACCESS SURGERY is a surgeon located in WILLOUGHBY, OH. NPPES has assigned the NPI number 1124255278 to LAKE HEALTH PHYSICIAN GROUP VASCULAR ACCESS SURGERY on June 16, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LAKE HEALTH PHYSICIAN GROUP VASCULAR ACCESS SURGERY” is a dba name, the actual legal business name for this organization is LAKE HOSPITAL SYSTEM, INC.. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2086S0129X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Vascular Surgery

The NPI profile was previously updated about 15 years ago on Apr 25, 2011. 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 LAKE HEALTH PHYSICIAN GROUP VASCULAR ACCESS SURGERY below.

NPI Profile for
LAKE HOSPITAL SYSTEM, INC.

NPI Number
1124255278
Enumeration Date

(about 17 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
LAKE HOSPITAL SYSTEM, INC.
Doing Business As (dba): LAKE HEALTH PHYSICIAN GROUP VASCULAR ACCESS SURGERY
Primary location
36001 EUCLID AVE
B-3
WILLOUGHBY, OH 44094-4643
Phone: (440) 953-1898 Fax: (440) 953-9296
Mailing address
PO BOX 714328
COLUMBUS, OH 43271-4328
Phone: (440) 354-1899 Fax: (440) 354-1089
Organization Subpart
No
Authorized Official
RICHARD CICERO
SR. VP, BUSINESS DEVELOPMENT
Phone: (440) 354-1739
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
2086S0129X
- Surgery / Vascular Surgery (Primary)
208600000X
- Surgery

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.