Lake, Gary Mathers
Lake, Gary Mathers is an individual health care provider with primary practice located at 1300 Mcfarland Blvd Ne Ste 150, Tuscaloosa AL 35406-2283. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Lake, Gary Mathers can be contacted via phone (205) 758-9041.Contact Information
Primary practice address
1300 Mcfarland Blvd Ne Ste 150
Tuscaloosa AL 35406-2283
Phone: (205) 758-9041
Fax: (205) 345-8328
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 18921 | Alabama |
Profile Details
| NPI number | 1124056916 |
|---|---|
| LBN Legal business name | Lake, Gary Mathers |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2006 |
| Last updated | Jul 18th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124056916 | NPPES |
| Alabama | Other | 051025432 | BLUE CROSS BLUE SHIELD |
| Alabama | MEDICAID | 000025432 | BLUE CROSS BLUE SHIELD |
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