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General NPI Number Information
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NPI Number | 1578742631
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Entity Type | Individual
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Provider Name | CARRIE A LAKIN DPM
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Gender | Female
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 331 LAIDLEY ST SUITE 602
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City | CHARLESTON
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State | WV
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Zip | 25301-1619
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Country | US
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Telephone | 304-347-3668
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11528
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City | CHARLESTON
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State | WV
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Zip | 25339-1528
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Country | US
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Telephone | 304-347-3668
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0359
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License Number State | WV
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