| NPI | 1639134158 |
|---|---|
| Doing Business As | LAKE REGIONAL MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KEVIN MCROBERTS CEO 573-348-8756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2024-11-04 |