Mr Kenneth Douglas Lake, PA-C in Asheboro, NC - Medicare Physician Assistant

Mr Kenneth Douglas Lake, PA-C is a medicare enrolled "Physician Assistant" in Asheboro, North Carolina. His current practice location is 300 Mack Rd, Asheboro, North Carolina. You can reach out to his office (for appointments etc.) via phone at (336) 625-1172.

Mr Kenneth Douglas Lake is licensed to practice in North Carolina (license number 101208) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1518981927.

Contact Information

	Mr Kenneth Douglas Lake, PA-C
	300 Mack Rd, Asheboro, NC 27205-1066
	(336) 625-1172
	(336) 625-6434

Provider's Profile

Full Name	Mr Kenneth Douglas Lake
Gender	Male
Speciality	Physician Assistant
Location	300 Mack Rd, Asheboro, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1518981927
Provider Enumeration Date: 07/27/2006
Last Update Date: 02/04/2019

Medicare PECOS Information:

PECOS PAC ID: 6608815915
Enrollment ID: I20050427000029

Medical Identifiers

Medical identifiers for Mr Kenneth Douglas Lake such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1518981927	NPI	-	NPPES
1582K	Other	NC	BCBS NC
1518981927	Medicaid	NC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	101208 (North Carolina)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kenneth Douglas Lake is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Kenneth Douglas Lake, PA-C Po Box 2005, Asheboro, NC 27204-2005 Ph: (336) 625-1172	Mr Kenneth Douglas Lake, PA-C 300 Mack Rd, Asheboro, NC 27205-1066 Ph: (336) 625-1172

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Physician Assistant Nurses in Asheboro, NC

Brian Conrad, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 503 N Fayetteville St, Asheboro, NC 27203 Phone: 336-460-0794
Kaitlin Michele West, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 713 S Fayetteville St, Asheboro, NC 27203 Phone: 336-625-2467
Jamie Webb Robinson, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 197 North Carolina 42 East, White Oak Urgent Care, Asheboro, NC 27203 Phone: 336-625-2560
Amber Nodal, P.A.-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 364 White Oak St, Asheboro, NC 27203 Phone: 336-625-5151
Holly Marie O'grady Vanbencoten, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1714 Back Creek Ct, Asheboro, NC 27205 Phone: 704-796-1309
Kelly J Trogdon, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 360 Sunset Ave, Asheboro, NC 27203 Phone: 336-625-8410 Fax: 336-625-8405
Julie A Jasienowski, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 364 White Oak St, Asheboro, NC 27203 Phone: 800-815-7491 Fax: 843-237-9736

Mr Kenneth Douglas Lake, PA-C - Medicare Physician Assistant in Asheboro, NC