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

Lakeside Vision Inc

Organization Optometrist · NPI 1790789550

Lakeside Vision Inc is an Optometrist in Prudenville, Michigan. Licensed in Michigan. Registered with an NPI since 2005.

Licensed in
MI
In the registry since
2005
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

888 W Houghton Lake Dr
Prudenville, MI 48651-9451
Phone: (989) 366-7525
Fax: (989) 366-5405
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence MI2953 (MI)

Record details

NPI number1790789550
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Boggs — Office Manager · (989) 366-7525
NPI enumeratedJune 9, 2005
Last updated in NPPESJuly 16, 2008
Mailing address888 W Houghton Lake Dr, P O Box 20, Prudenville, MI 48651-9451

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