JON M LAKE M.D. - NPI 1376561696 - Family Medicine in Jackson, MI

Q: What is Jon Lake's NPI number?

The NPI number for Jon Lake is 1376561696. It was assigned to this individual provider in the NPPES registry on July 17, 2006.

Q: What is Jon Lake's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jon Lake was last updated on February 17, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Jon M Lake M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JON M LAKE M.D. (NPI 1376561696) is an individual family medicine provider in Jackson, Michigan, licensed in Michigan (4301068180) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1376561696

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJON M LAKECredential: M.D.

Location Address400 HINCKLEY BLVD, SUITE 100Jackson, MI 49203-6125

Mailing AddressPo Box 67000, Department 272801Detroit, MI 48267-0002 · (517) 784-0588 · Fax (517) 784-3866

Phone(517) 784-0588

Fax(517) 784-3866

Sole ProprietorNo

Enumeration DateJuly 17, 2006

Last NPPES UpdateFebruary 17, 20212 updates tracked since enumeration

NPPES CertifiedFebruary 17, 2021

✔ NPI 1376561696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 4301068180

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 is not limited by age, sex, organ system, or disease entity.

400 HINCKLEY BLVD, Jackson, MI 49203

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