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Jon M Lake

  • Male

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):