Family Practice by the Lake LLC
Family Practice by the Lake LLC is a Family Medicine Physician in Coeur D Alene, Idaho. Registered with an NPI since 2016.
- In the registry since
- 2016
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1875 N Lakewood Dr Ste 205Coeur D Alene, ID 83814-4928
Phone: (208) 966-4087
Fax: (208) 966-4031
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X |
|---|---|
| Nurse Practitioner | Taxonomy 363L00000X |
Record details
| NPI number | 1295283810 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jacqueline Wagner — Owner · (208) 661-1181 |
| NPI enumerated | September 12, 2016 |
| Last updated in NPPES | March 25, 2024 |
| Certification date | March 25, 2024 |
| Mailing address | 1875 N Lakewood Dr Ste 205, Coeur D Alene, ID 83814-4928 |
Other providers in Coeur D Alene
-
Samantha Anne Easterly, DO
1090 W Park Pl, Coeur D Alene, ID 83814-2785 · (208) 620-5250
-
Geoffrey Thomas Emry, MD
920 W Ironwood Dr Ste 101, Coeur D Alene, ID 83814-2464 · (208) 667-4557
-
Family Health Associates, PA
914 W Ironwood Dr Ste 101, Coeur D Alene, ID 83814-4927 · (208) 765-5922
-
Family Medicine Coeur D'Alene, PA
700 W Ironwood Dr Ste 101, Coeur D Alene, ID 83814-2666 · (208) 667-2541
-
Shana D Fogarty, MD
2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 · (208) 625-5085
-
Ryan John Gilles, MD
1919 Lincoln Way 315, Coeur D Alene, ID 83814-2527 · (208) 625-6000
-
M Jill Gronholz-Dero
914 W Ironwood Dr, Coeur D Alene, ID 83814-4927 · (208) 765-5922
-
Leonard D Guth, MD
700 W Ironwood Dr Ste 170E, Coeur D Alene, ID 83814-2656 · (208) 667-9110