Provider Demographics
NPI:1851010789
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:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SKAZIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-582-7486
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-0404
Mailing Address - Country:US
Mailing Address - Phone:256-582-7486
Mailing Address - Fax:
Practice Address - Street 1:9625 US HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-0129
Practice Address - Country:US
Practice Address - Phone:256-660-1613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAKEVIEW FAMILY FOOT CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty