Lake, Douglas R.

Lake, Douglas R. is an individual health care provider with primary practice located at 1215 Duff Avenue , Ames IA 50010-3014. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Lake, Douglas R. can be contacted via phone (515) 239-4456.

Contact Information

Primary practice address
1215 Duff Avenue Ames IA 50010-3014
Phone: (515) 239-4456
Fax: (515) 239-4761
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 37861 Iowa
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 23902 South Carolina
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 24188 Nebraska
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X A99351 California

Profile Details

NPI number 1194808394
LBN Legal business name Lake, Douglas R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Nov 3rd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194808394 NPPES
Other 01626 BC/BS NE
MEDICAID 10025186700 BC/BS NE
MEDICAID 10025173600 BC/BS NE
MEDICAID 69958751 BC/BS NE
MEDICAID 1194808394 BC/BS NE
Other 200145166 BC/BS NE
Other 201477608 BC/BS NE
Other P00619095 BC/BS NE
Other P00619099 BC/BS NE
MEDICAID 7729430 BC/BS NE
MEDICAID 10025248800 BC/BS NE
Other 34783 BC/BS NE

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