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Contact Information

JOHN T LAKE, MD
60 DOCTORS PARK LOWR LEVEL
CAPE GIRARDEAU, MO63703
 Phone: 573-519-4949
 Fax: 573-519-4665
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for JOHN T LAKE · (Male)

NPI # 1629270194
Status Active
Credentials MD
Entity Individual
Enumeration date 06/05/2007
Last updated 08/01/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 108382
Hospital affiliation(s) Not Available
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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