Dr Tierney A Lake, MD | |
1010 Three Springs Blvd, Durango, CO 81301-8296 | |
(970) 764-3352 | |
(970) 764-3375 |
Full Name | Dr Tierney A Lake |
---|---|
Gender | Female |
Speciality | Internal Medicine |
Experience | 14 Years |
Location | 1010 Three Springs Blvd, Durango, Colorado |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194041210 | NPI | - | NPPES |
52399 | Other | CO | STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | DR.0052399 (Colorado) | Secondary |
208M00000X | Hospitalist | DR.0052399 (Colorado) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Mercy Regional Medical Center | Durango, CO | Hospital |
St Mark's Hospital | Salt lake city, UT | Hospital |
Lone Peak Hospital | Draper, UT | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Catholic Health Initiatives Colorado | 8022927342 | 972 |
Entity Name | Catholic Health Initiatives Colorado |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356783351 PECOS PAC ID: 8022927342 Enrollment ID: O20031215000462 |
Entity Name | Colorado West Healthcare System |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497723407 PECOS PAC ID: 3971491887 Enrollment ID: O20040310000712 |
Mailing Address | Practice Location Address |
---|---|
Dr Tierney A Lake, MD Po Box 800022, Kansas City, MO 64180-0022 Ph: (800) 953-0104 | Dr Tierney A Lake, MD 1010 Three Springs Blvd, Durango, CO 81301-8296 Ph: (970) 764-3352 |
Julie Pysklo, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 1010 Three Springs Blvd, Durango, CO 81301 Phone: 970-247-4311 | |
Jennifer K Heinicke, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 1010 Three Springs Blvd, Durango, CO 81301 Phone: 970-247-4311 | |
Jillian J Nickelsen, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 1010 Three Springs Blvd, Durango, CO 81301 Phone: 970-247-4311 | |
Frederick O Ochsner, MD Hospitalist Medicare: Not Enrolled in Medicare Practice Location: 1 Mercado St Ste 160, Durango, CO 81301 Phone: 970-385-9850 Fax: 970-385-9854 |