Provider Demographics
NPI:1619187945
Name:LAKEY, MEREDITH ASHLEY (MD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ASHLEY
Last Name:LAKEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5305 MEMPHIS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-1735
Mailing Address - Country:US
Mailing Address - Phone:205-249-4376
Mailing Address - Fax:
Practice Address - Street 1:1516 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-0328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN103661207ZP0101X
MN51167207ZP0101X
AL25701207ZP0102X
MDD68653207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAENROLLEDMedicaid
WI35342400Medicaid
MNENROLLEDMedicaid
MD417546800Medicaid
MD155091YWBMedicare PIN
MN220001268Medicare PIN