Lakeside Pediatric & Adolescent Medicine, Pllc

Pediatric Adolescent Medicine

Lakeside Pediatric & Adolescent Medicine, Pllc is a Coeur D'alene, Idaho based Pediatric center with medical specialization in Pediatric Adolescent Medicine. It is located at 980 W Ironwood Dr, Ste 302, Coeur D'alene, Idaho - 83814-2601. They can be contacted on phone at 208-292-5437 and fax number 208-292-5441.
NPI number (Unique professional ID) for Lakeside Pediatric & Adolescent Medicine, Pllc is 1003975087 which was assigned by NPPES on 06 Dec, 2006 and it was last updated on 12 Jul, 2012.
Lakeside Pediatric & Adolescent Medicine, Pllc specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Lakeside Pediatric & Adolescent Medicine, Pllc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
Specialization :Pediatrics Adolescent Medicine
Provider Name :Lakeside Pediatric & Adolescent Medicine, Pllc
Business Address:
Lakeside Pediatric & Adolescent Medicine, Pllc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
Primary Address :980 W Ironwood Dr, Ste 302
Coeur D'alene, ID, 83814-2601
United States
Phone Number :208-292-5437
Fax Number :208-292-5441
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
NPI Number : 1003975087
NPI Entity Type : Organization
First Enrolment Date : 06 Dec, 2006
Last Updated On : 12 Jul, 2012
Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
Authorized Official Name :Dianar Vanhook
Official Title or Position :OFFICE MANAGER
Phone Number :208-292-5437
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lakeside Pediatric & Adolescent Medicine, Pllc are as mentioned. Primary taxonomy code for Lakeside Pediatric & Adolescent Medicine, Pllc is 2080A0000X (Pediatrics Adolescent Medicine).
Taxonomy Code SpecialityPrimaryLicense No.State
2080A0000XPediatrics Adolescent MedicineYes
Legacy Identifiers:
Other legacy medical identifiers of Lakeside Pediatric & Adolescent Medicine, Pllc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
IdentifierIdentifier TypeStateIssuer
806408200MEDICAIDID
4010138351OtherIDREGENCE BLUE SHIELD GROUP
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
Mailing Address :980 W Ironwood Dr, Ste 302
Coeur D'alene, ID, 83814-2601
United States
Phone Number :208-292-5437
Fax Number :208-292-5441
Business Location:
Patients can refer following map for directions to Lakeside Pediatric & Adolescent Medicine, Pllc practice address. Don't forget to take prior appointment before visiting.

** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.