Provider Demographics
NPI:1194153841
Name:LAKINS, PAUL GARY
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:GARY
Last Name:LAKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SHERWAY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-2236
Mailing Address - Country:US
Mailing Address - Phone:865-357-2900
Mailing Address - Fax:865-357-1210
Practice Address - Street 1:151 SHERWAY RD STE 2
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2236
Practice Address - Country:US
Practice Address - Phone:865-357-2900
Practice Address - Fax:865-357-1210
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier