Provider Demographics
NPI:1992783492
Name:LAKIN, DOUGLAS M (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:M
Last Name:LAKIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9977 N 90TH ST
Mailing Address - Street 2:#180
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4423
Mailing Address - Country:US
Mailing Address - Phone:480-614-5800
Mailing Address - Fax:480-614-6322
Practice Address - Street 1:9977 N 90TH ST
Practice Address - Street 2:#180
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4423
Practice Address - Country:US
Practice Address - Phone:480-614-5800
Practice Address - Fax:480-614-6322
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ19362207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ25901OtherPTAN
AZ19362OtherSTATE MEDCIAL LICENSE
AZ19362OtherSTATE MEDCIAL LICENSE
AZZ25901OtherPTAN