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Contact Information

JARED R LAKE, MD
5121 COTTONWOOD ST
MURRAY, UT84107-5701
 Phone: 801-507-5248
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for JARED R LAKE · (Male)

NPI # 1720286255
Status Active
Credentials MD
Entity Individual
Enumeration date 07/05/2007
Last updated 12/05/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 7890667-1205
Hospital affiliation(s)
  • LDS HOSPITAL - (Acute Care)
    8TH AVENUE AND C STREET
    SALT LAKE CITY, UT 84143
  • THE ORTHOPEDIC SPECIALTY HOSPITAL - (Acute Care)
    5848 SOUTH 300 EAST
    MURRAY, UT 84107
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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