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Mr. Lance Lincoln Pride, PA
Medical Physician Assistant in Kalamazoo, Michigan
NPI 1437432036

Lance Lincoln Pride is a Medical Physician Assistant based in Ypsilanti, MI and is specialized in Medical. Lance Lincoln Pride practices in Kalamazoo, MI and has the professional credentials of PA. The NPI Number for Lance Lincoln Pride is 1437432036 and holds a License No. 5601006118 (Michigan).

The current practice location address for Lance Lincoln Pride is 601 John St Ste M-460, Kalamazoo, MI and can be reached out via phone at 269-341-7333 and via fax at 269-341-7371.

Location: 601 John St Ste M-460, Kalamazoo, MI, 48197-1051
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1437432036
Provider Name
Lance Lincoln Pride
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
601 John St Ste M-460, Kalamazoo, MI, 48197-1051
Phone Number
269-341-7333
Fax Number
269-341-7371
Provider Enumeration Date
09/21/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
VV9406A 01 VA MEDICARE PTAN
14374322036 05 VA
10111084P 01 VA SENTARA HEALTH PLANS
14374322036 01 VA TRICARE
institution
Provider Business Practice Location Address Details
Address
601 John St Ste M-460
City
Kalamazoo
State
Michigan
Zip
49007-5355
Phone Number
269-341-7333
Fax Number
269-341-7371
person
Provider Business Mailing Address Details
Address
601 John St Ste M-460
City
Kalamazoo
State
Michigan
Zip
49007-5355
Phone Number
269-341-7333
Fax Number
269-341-7371
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
5601006118 (Michigan)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
363AS0400X
License No.
5601006118 (Michigan)
Definition
Definition to come...
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