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 is a Dermatology Physician 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
Phone: (765) 838-3428
Fax: (765) 838-3440
Show map & directions

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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