Organization
FOUR CORNERS FOOT AND ANKLE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAYSE L LAKE DPM (OWNER)
(970) 259-5303
Entity
Organization
Contact information
Practice address
1266 ESCALANTE DR, SUITE 201, DURANGO, CO 81301-7490
(970) 259-5303
(970) 259-3510
Mailing address
1266 ESCALANTE DR, SUITE 201, DURANGO, CO 81301-7490
(970) 259-5303
(970) 259-3510
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
POD710
CO
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51073277
—
CO
05
—
80527850
—
CO
Enumeration date
06/05/2013
Last updated
02/19/2026
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