Russell William Lake in Richmond Hill - Family Medicine
Russell William Lake - NPI 1104081082
Russell William Lake is a Family Medicine in Richmond Hill, Georgia. Russell William Lake practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Russell William Lake is 1104081082. The last update date is 2021-10-19.
Russell William Lake's current location address is 10055 Ford Avenue, Richmond Hill, Georgia. You can contact this provider via phone number 9128199601 and fax number 9128199605. The mailing address for Russell William Lake is 10055 Ford Avenue, Richmond Hill, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Russell William Lake |
|---|---|
| Address | 10055 Ford Avenue, Richmond Hill, Georgia |
| Phone Number | 9128199601 |
| Fax Number | 9128199605 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1104081082 |
|---|---|
| Provider Enumeration Date | 2008-07-21 |
| Last Updated Date | 2021-10-19 |
Provider Mailing Address Detail
| Address | 10055 Ford Avenue |
|---|---|
| City | Richmond Hill |
| State | Georgia (GA) |
| Post Code | 31324 |
| Phone Number | 9128199601 |
| Fax Number | 9128199605 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 31545 |
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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 i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200480198D | GA | -- | |
| 003213522B | GA | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Russell William Lake by the Centers for Medicare & Medicaid Services?
The Russell William Lake has been issued the NPI (National Provider Identifier) 1104081082. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Russell William Lake is geographically located?
The Russell William Lake is physically situated at the following location: 10055 Ford Avenue, Richmond Hill, GA, 31324.
What is Russell William Lake's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Russell William Lake is Family Medicine, and the taxonomy classification code that categorizes this area of expertise is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1104081082 to Russell William Lake?
The Centers for Medicare & Medicaid Services assigned the 1104081082 to Russell William Lake on 2008-07-21.
When was the information regarding Russell William Lake, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Russell William Lake, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2021-10-19.
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