Organization
LAKES MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES D LAYMAN M.D. (M.D.)
(907) 357-0820
Entity
Organization
Contact information
Practice address
5050 DUNBAR STREET, SUITE D, WASILLA, AK 99654
(907) 357-0820
(907) 357-0821
Mailing address
PO BOX 876009, WASILLA, AK 99687-6009
(907) 357-0820
(907) 357-0821
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083701858
NPI # GERALD EDWARD MANNI
AK
01
—
1154418945
NPI # DR. CHARLES D. LAYM
AK
Enumeration date
07/17/2007
Last updated
07/21/2022
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