Lakeside Family Medicine

NPI #1295064178 in Kingston, Oklahoma

Provider Information

NPI Number
1295064178
Entity Type
Organization
Organization Name
Lakeside Family Medicine
Primary Specialty
Family Medicine
Enumeration Date
Dec 23, 2009
Last Updated
Dec 23, 2009

Practice Location

Address
21 N. MAIN STREET
ZIP Code
73439-1798
Phone
(580) 226-1010

Authorized Official

Name
DR. PAMELA E AHEARN, MD
Title
OWNER/PRESIDENT
Phone
(580) 226-1010

Specialties & Taxonomy Codes

Specialty
Family Medicine

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