Provider Demographics
NPI:1699742502
Name:LAKEY, WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:LAKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 SAINT JOHNSBURY RD
Mailing Address - Street 2:NORTH COUNTRY PEDIATRICS
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-3437
Mailing Address - Country:US
Mailing Address - Phone:603-444-2803
Mailing Address - Fax:603-444-4073
Practice Address - Street 1:580 SAINT JOHNSBURY RD
Practice Address - Street 2:NORTH COUNTRY PEDIATRICS
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-3437
Practice Address - Country:US
Practice Address - Phone:603-444-2803
Practice Address - Fax:603-444-4073
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8244208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH136480OtherCIGNA HEALTHCARE
NH80300008Medicaid
VT1002863Medicaid
NH380843OtherMVP
VT19129OtherBLUE CROSS/BLUE SHIELD
NHA73529OtherHARVARD PILGRIM HEALTHCAR
NHA73529Medicare UPIN
NH80300008Medicaid