Lakeside Medical Pllc

NPI #1376210500 in Lakeside, Arizona

Provider Information

NPI Number: 1376210500
Entity Type: Organization
Organization Name: Lakeside Medical Pllc
Primary Specialty: Family Medicine
Enumeration Date: Aug 25, 2021
Last Updated: Mar 16, 2022

Practice Location

Address: 300 W WHITE MOUNTAIN BLVD #C
City: Lakeside
State: Arizona
ZIP Code: 85929-7014
Phone: (928) 367-6828

Authorized Official

Name: DR. GAYLON E CRAWFORD, D.O.
Title: PHYSICIAN
Phone: (928) 367-6828

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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