Jon M Lake is a Family Medicine in Detroit, Michigan. Jon M Lake practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Jon M Lake is 1376561696. The last update date is 2021-02-17.
Jon M Lake's current location address is Po Box 67000, Detroit, Michigan. You can contact this provider via phone number 5177840588 and fax number 5177843866. The mailing address for Jon M Lake is Po Box 67000, Detroit, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jon M Lake |
|---|---|
| Address | Po Box 67000, Detroit, Michigan |
| Phone Number | 5177840588 |
| Fax Number | 5177843866 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1376561696 |
|---|---|
| Provider Enumeration Date | 2006-07-17 |
| Last Updated Date | 2021-02-17 |
Provider Mailing Address Detail
| Address | Po Box 67000 |
|---|---|
| City | Detroit |
| State | Michigan (MI) |
| Post Code | 482670002 |
| Phone Number | 5177840588 |
| Fax Number | 5177843866 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 4301068180 |
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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 |
|---|---|---|---|
| P00420975 | MI | RR MEDICARE | |
| 80169124 | MI | RR MEDICARE | |
| 5187092-10 | MI | -- |
Post Comment/ Review Below
What is the Jon M Lake's unique identification number?
The Jon M Lake has been assigned the NPI (National Provider Identifier) Number 1376561696 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Jon M Lake located?
The Jon M Lake is located at Po Box 67000, Detroit, MI 482670002.
What is Jon M Lake's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jon M Lake's area of specialization is Family Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1376561696 to Jon M Lake?
The Centers for Medicare & Medicaid Services originally issued the 1376561696 to Jon M Lake on 2006-07-17.
When was the information regarding Jon M Lake most recently updated?
The details pertaining to the Jon M Lake, including its address, specialty, and other relevant information, were last refreshed on 2021-02-17.