Provider Demographics
NPI:1306045588
Name:LAKEVIEW FAMILY FOOT CARE L.L.C.
Entity Type:Organization
Organization Name:LAKEVIEW FAMILY FOOT CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:SKAZIAK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:256-582-7486
Mailing Address - Street 1:P.O. BOX 404
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-1840
Mailing Address - Country:US
Mailing Address - Phone:256-582-7486
Mailing Address - Fax:256-582-9844
Practice Address - Street 1:1604 BLOUNT AVE
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-1840
Practice Address - Country:US
Practice Address - Phone:256-582-7486
Practice Address - Fax:256-582-9844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL171213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
51078853SKAOtherBLUE CROSS BLUE SHIELD
AL000078853OtherMEDICARE LEGACY PROVIDER#
ALDP9341OtherRAILROAD MEDICARE
2710035OtherUNITED HEALTH CARE #
38652OtherHEALTH PARTNERS #
2710035OtherUNITED HEALTH CARE #
38652OtherHEALTH PARTNERS #