Provider Demographics
NPI:1205187226
Name:YIN LOK LAI, M.D.,P.C.
Entity Type:Organization
Organization Name:YIN LOK LAI, M.D.,P.C.
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YIN LOK
Authorized Official - Middle Name:
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-451-5403
Mailing Address - Street 1:5069 BUFORD HWY NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-1102
Mailing Address - Country:US
Mailing Address - Phone:770-451-5403
Mailing Address - Fax:770-451-5548
Practice Address - Street 1:5069 BUFORD HWY NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30340-1102
Practice Address - Country:US
Practice Address - Phone:770-451-5403
Practice Address - Fax:770-451-5548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA25881174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00017105AMedicaid