Dr. Jason Greer Lake
Pediatrician Pediatric Infectious Diseases
1 Childrens Pl 3s34
Saint Louis
, Missouri 63110-1002
Dr. Jason Greer Lake
Pediatrician Pediatric Infectious Diseases
1 Childrens Pl 3s34
Saint Louis
, Missouri 63110-1002
(314) 454-4102
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About
Features
Specialties
- Pediatrician
- Pediatric Infectious Diseases
Languages spoken
- English
Location
First Address
- Dr. Jason Greer Lake
- 1 Childrens Pl 3s34
- Saint Louis, MO
- Zip : 63110-1002
- Fax : (314) 454-4102
- Phone : (314) 454-6006
Second Address
- Dr. Jason Greer Lake
- 1 Childrens Pl 3s34
- Saint Louis, MO
- Zip : 63110-1002
- Fax : (314) 454-4102
- Phone : (314) 454-6006
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208000000X | Pediatrician | 2012015095 | MO |
| Y | 2080P0208X | Pediatric Infectious Diseases | 11680333-1205 | UT |
National Provider Identifier
| NPI | 1609195189 |
|---|---|
| Provider Name | Dr. Jason Greer Lake |
| First Address | Saint Louis, MO 63110-1002 |
| Second Address | Saint Louis, MO 63110-1002 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/05/2010 |
| Last Update Date | 17/11/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.