Doctor Name: | DR. LADD DANIEL LAKE |
NPI Number: | 1023076874 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 22147 |
Business Practice Address: | 601 W Leota St North Platte, NE - 691016525 |
Business Phone Number: | 3086967491 |
Business Fax Number: | 3086967432 |
Mailing Address: | Po Box 362, NORTH PLATTE |
State: | NE |
Postal Code: | 691030362 |
Phone Number: | 8664777013 |
Fax Number: | 8669022445 |
NPI Enumeration Date: | 05/02/2006 |
NPI Last Update Date: | 05/31/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 22147 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |