HAROLD J LAKE JR. (NPI# 1598098824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598098824 |
| Entity Type | Individual |
| Full Name | HAROLD J LAKE JR. |
| Credential | PA-C |
| Practice Address |
419 S Coral St Kalkaska MI 49646-2503 |
| Mailing Address |
Po Box 916 Traverse City MI 49685-0916 |
| Practice Telephone | 2312587500 |
| Practice Fax Number | 2312587592 |
| Mailing Telephone | 8004373615 |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2016-11-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 5601005633 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601005633 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
419 S CORAL ST |
| City | KALKASKA |
| State | MI |
| Zip Code | 49646-2503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215931720 | Jason T Hicks | Physician Assistant | 419 S Coral St, Kalkaska, MI 49646-2503 | 2005-06-13 |
| 1487289930 | Tina Jacobs | Pharmacist | 419 S Coral St, Kalkaska, MI 49646-2503 | 2020-03-05 |
| 1760028419 | Jill Kathleen Murphy | Counselor | 419 S Coral St, Kalkaska, MI 49646-2503 | 2019-11-18 |
| 1053969949 | Hannah Parrish | Speech-Language Pathologist | 419 S Coral St, Kalkaska, MI 49646-2503 | 2019-09-03 |
| 1033674072 | Lindsey Marie Ranstadler | Nurse Practitioner | 419 S Coral St, Kalkaska, MI 49646-2503 | 2019-02-04 |
| 1871094375 | Matthew James Rider | Physical Therapist | 419 S Coral St, Kalkaska, MI 49646-2503 | 2018-02-21 |
| 1386144970 | Kassi Burkam | Physical Therapist | 419 S Coral St, Kalkaska, MI 49646-2503 | 2018-02-20 |
| 1407356942 | Nancy Yvonne Grody | Physical Therapist | 419 S Coral St, Kalkaska, MI 49646-2503 | 2018-02-20 |
| 1790285252 | Lene Oestlyngen Hall | Physical Therapist | 419 S Coral St, Kalkaska, MI 49646-2503 | 2018-02-20 |
| 1013417609 | Holly Jo Swinehart | Occupational Therapist | 419 S Coral St, Kalkaska, MI 49646-2503 | 2018-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245737915 | Leanne Berry | Physical Therapist | 409 S. Coral, Kalkaska, MI 49646 | 2018-04-10 |
| 1770030488 | Duane Allen | Pharmacist | 784 South Cedar St Ste E, Kalkaska, MI 49646 | 2016-09-10 |
| 1831524040 | Stephanie Marie Murden | Homemaker | 5031 Wagenschutz Rd., Kalkaska, MI 49646 | 2013-09-06 |
| 1508202615 | Dynamic Hearing Care Systems LLC. | Hearing Instrument Specialist | 303 N. Cedar St., Kalkaska, MI 49646 | 2013-05-15 |
| 1063722965 | Robin Lee Nelson | Massage Therapist | 110 W. Fourth St., Kalkaska, MI 49646 | 2010-10-14 |
| 1578886057 | Your Community Above and Beyond Home Health Care | In Home Supportive Care | 303 Cedar Street, Kalkaska, MI 49646 | 2010-03-11 |
| 1891980306 | Kalkaska Memorial Health Center | Clinic/Center | 415 2nd St., Kalkaska, MI 49646 | 2007-09-07 |
| 1114121001 | Kalkaska Chiropractic Center | Chiropractor | 224 S Cedar St, Kalkaska, MI 49646 | 2007-06-13 |
| 1659490860 | Active Brace and Limb | Prosthetic/Orthotic Supplier | 215 S Cedar Street, Kalkaska, MI 49646 | 2007-03-28 |
| 1205849882 | Robert E Molter Jr. | Optometrist | 882 M 72 Nw, Kalkaska, MI 49646 | 2006-08-14 |
| Find all providers in zip 49646 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215931720 | Jason T Hicks | Physician Assistant | 419 S Coral St, Kalkaska, MI 49646-2503 | 2005-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616687 | Alexandria Jaclyn Miller | Physician Assistant | 4700 Chipman Dr, Waterford, MI 48327-3413 | 2020-10-15 |
| 1639777287 | Piotr Z Purzycki | Physician Assistant | 41400 Dequindre Rd Ste 101, Sterling Heights, MI 48314-3751 | 2020-10-15 |
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1326656844 | Dominic Farrell | Physician Assistant | 224 Portchester Rd, Holland, MI 49424-2628 | 2020-07-21 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1013535343 | Maria Pavia | Physician Assistant | 41302 Scarborough Ln, Novi, MI 48375-2893 | 2020-07-13 |
| 1073130241 | Kelly F Esper | Physician Assistant | 9043 Glenwood Ln, Northville, MI 48168-9129 | 2020-07-02 |
| 1811513971 | Tasha Baker | Physician Assistant | 5444 E Whitefeather Rd, Pinconning, MI 48650-8407 | 2020-06-24 |
| 1437770054 | Sterling Ryan Maxfield | Physician Assistant | 6187 Oak Grove Rd, Howell, MI 48855-8247 | 2020-05-05 |
| 1760018808 | Rachel Renee Mackmin | Physician Assistant | 41498 Mary Kay Dr, Clinton Township, MI 48038-1989 | 2020-03-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.