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NPI Code Detail

MEDICARE: DR. WILLIAM AUSTIN DAKE MD

MEDICARE: DR. WILLIAM AUSTIN DAKE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician29268KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2080148255OTHERRAILROAD

General Provider Information

NPI Number : 1902858228
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM AUSTIN DAKE MD
Provider Business Mailing Address
First Line : 496 SOUTHLAND DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40503-1827
Country : US
Telephone Number : 859-288-2392
Fax Number : 859-721-3918
Provider Business Practice Location Address
First Line : 496 SOUTHLAND DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40503-1827
Country : US
Telephone Number : 859-288-2425
Fax Number : 859-288-7510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 03/07/2023

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Directions to “ DR. WILLIAM AUSTIN DAKE MD” Practice Location

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