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Contact Information

JEFFREY M LAKE
405 E EXCELSIOR AVE
VINITA, OK74301
 Phone: 918-256-6476
 Fax: 918-256-3628
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Other Service Providers

175T00000X
Indicates primary specialty

NPI Profile & details for JEFFREY M LAKE · (Male)

NPI # 1316432115
Status Active
Credentials
Entity Individual
Enumeration date 06/25/2018
Last updated 07/30/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers Not Available
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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