JOSEPH ROBERT LAKE

JACKSON, MS
NPI1538797626
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: MS  31395)
Enumeration Date2020-04-01
Last Update Date2023-09-15
Business Address
JOSEPH ROBERT LAKE MD
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-815-8010
Mailing Address
JOSEPH ROBERT LAKE MD
504 CLINTON CENTER DRIVE CBO SUITE 4300
CLINTON, MS 39056
Phone number: 601-815-2005
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