IndividualActive
Gary Lake, MD
NPI 1124056916 · Otolaryngology Physician · Tuscaloosa, AL
Provider details
- NPI number
- 1124056916
- Entity type
- Individual
- Primary specialty
- Otolaryngology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 18921 (AL)
Practice location
1300 Mcfarland Blvd Ne
Ste 150
Tuscaloosa, AL 35406-2283
Phone: (205) 758-9041
Fax: (205) 345-8328
Mailing address
1300 Mcfarland Blvd Ne
Tuscaloosa, AL 35406-2283
Registry dates
- Enumerated
- 2006-06-29
- Last updated
- 2024-07-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.