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LAKESIDE MEDICAL PLLC
NPI 1376210500
Family Medicine in Lakeside, AZ

Active since August 25, 2021
300 W WHITE MOUNTAIN BLVD #C, LAKESIDE, AZ 85929(928) 367-6828(928) 367-4037 Get Directions Write a Review

NPPES record last updated: March 16, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Lakeside Medical Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESIDE MEDICAL PLLC (NPI 1376210500) is a healthcare organization registered as a family medicine in Lakeside, Arizona and active in the NPI registry since August 2021. The organization lists Gaylon E Crawford, Physician, as its authorized official.

NPPES Registry Identity

NPI1376210500
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLAKESIDE MEDICAL PLLC
Location Address300 W WHITE MOUNTAIN BLVD #CLakeside, AZ 85929-7014
Mailing Address300 W White Mountain Blvd #cLakeside, AZ 85929-7014 · (928) 367-6828 · Fax (928) 367-4037
Phone(928) 367-6828
Fax(928) 367-4037
Organization SubpartNo
Authorized OfficialGaylon E CrawfordPhysician · (928) 367-6828
Enumeration DateAugust 25, 2021
Last NPPES UpdateMarch 16, 2022
NPPES CertifiedMarch 16, 2022
✔ NPI 1376210500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Other Identifiers 1

Medicaid368333AZ

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeside Medical PLLC's NPI number?

The NPI number for Lakeside Medical PLLC is 1376210500. It was assigned to this organization in the NPPES registry on August 25, 2021.

Where is Lakeside Medical PLLC located?

Lakeside Medical PLLC is located at 300 W White Mountain Blvd #c, Lakeside, AZ 85929. The listed phone number is (928) 367-6828.

What is Lakeside Medical PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Lakeside Medical PLLC was last updated on March 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.