Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lakeside Medical PLLC

Organization Family Medicine Physician · NPI 1376210500

Lakeside Medical PLLC is a Family Medicine Physician in Lakeside, Arizona. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

300 W White Mountain Blvd #C
Lakeside, AZ 85929-7014
Phone: (928) 367-6828
Fax: (928) 367-4037
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1376210500
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gaylon Crawford — Physician · (928) 367-6828
NPI enumeratedAugust 25, 2021
Last updated in NPPESMarch 16, 2022
Certification dateMarch 16, 2022
Mailing address300 W White Mountain Blvd #C, Lakeside, AZ 85929-7014

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