| NPI | 1770681652 |
|---|---|
| Doing Business As | LAKEMOOR FAMILY PHYSICIANS |
| Entity Type | Organization |
| Authorized Contact | BETH A MAYNARD Vice President 865-305-6427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-06-05 |