Jon M Lake
Medical Specialty
Professional ID
- NPI: 1376561696
- PECOS ID: 1254242217
- Enrollment ID: I20061130000131
- Credential(MD, DO, DPM): MD
- Medical School: Wayne State University School Of Medicine
- Medical School Graduation Year: 1996
Hospital Service
- Hospital CCN1: 230092
- Business Name (LBN)1: Henry Ford Allegiance Health
Medical Practices
- Organization Name: W A Foote Memorial Hospital Inc
- Group Practice ID assigned by PECOS: 0244136067
- Number of Group Practice member: 345
Location
- Address1: 130 N Sherman St
- Address2: Henry Ford Allegiance Family Medicine Leslie
- City: Leslie
- State: Michigan
- Zip Code: 49251
- Phone Number: (517)205-2500
Location
- Address1: 205 N E Ave
- Address2:
- City: Jackson
- State: Michigan
- Zip Code: 49201
- Phone Number:
Location
- Address1: 2200 Springport Rd
- Address2:
- City: Jackson
- State: Michigan
- Zip Code: 49202
- Phone Number:
Location
- Address1: 813 W Michigan Ave
- Address2: Henry Ford Allegiance Endocrinology
- City: Jackson
- State: Michigan
- Zip Code: 49202
- Phone Number: (517)205-1000
Medical Practices
- Organization Name: Independent Observation Physicians Pllc
- Group Practice ID assigned by PECOS: 3577603604
- Number of Group Practice member: 128
Location
- Address1: 16001 W 9 Mile Rd
- Address2:
- City: Southfield
- State: Michigan
- Zip Code: 48075
- Phone Number: (248)849-3331
Location
- Address1: 205 N E Ave
- Address2:
- City: Jackson
- State: Michigan
- Zip Code: 49201
- Phone Number: (517)788-4880
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
- Used Electronic health record (EHR):