Provider Demographics
NPI:1083985014
Name:PAUL GARY LAKINS AH-MAZING ORTHOTICS
Entity Type:Organization
Organization Name:PAUL GARY LAKINS AH-MAZING ORTHOTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:LAKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-684-0533
Mailing Address - Street 1:151 SHERWAY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-2236
Mailing Address - Country:US
Mailing Address - Phone:865-357-2900
Mailing Address - Fax:865-357-1210
Practice Address - Street 1:151 SHERWAY RD STE 2
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2236
Practice Address - Country:US
Practice Address - Phone:865-357-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-23
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier