Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Dermatology Inc

Organization Dermatology Physician · NPI 1689898447

Lake Dermatology Inc provides Dermatology Physician services in Lafayette, Indiana. Licensed in Indiana. Registered with an NPI since 2007.

Licensed in
IN
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

15 Executive Dr Ste 4
Lafayette, IN 47905-3833 Not confirmed with CMS for 17 years — call before visiting
Phone: (765) 838-3428
Fax: (765) 838-3440
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 01055166A (IN)

Record details

NPI number1689898447
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Lake — President · (765) 538-3508
NPI enumeratedApril 12, 2007
Last updated in NPPESNovember 13, 2008
Mailing address15 Executive Dr, Suite 4, Lafayette, IN 47905-3833

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