Search › Georgia › 2085R0202X
Jack Lake, D.O
NPI 1932248101 · on the registry since 2007
Practice
- Address
- 2624 Dawson Rd
Albany, GA 31707 - Phone
- (229) 888-1624
- Organisation at this address
- Albany Diagnostic Center, Llc
American Health Imaging Of Georgia, LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 8
Additional practice sites
- 940 Ne 13th St, Oklahoma City, OK
Registry record
- Primary taxonomy
- 2085R0202X
2085R0202X
- Also registered as
- 2085R0202X
- Licence states on file
- GA, OK
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-10-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia