Gary Bradley Lake, MD

NPI #1679518708 in Tuba City, Arizona

Provider Information

NPI Number: 1679518708
Entity Type: Individual
Name: Gary Bradley Lake, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Credential: MD
Enumeration Date: Jun 20, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 167 NORTH MAIN STREET
City: Tuba City
State: Arizona
ZIP Code: 86045-0600
Phone: (928) 283-2501

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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