NPI 1043159130

Jasmine Lake

Practitioner Obstetrics & Gynecology Physician Macon, GA

Practice location

Address: 777 Hemlock St, Macon, GA 31201-2102
Phone: (478) 633-1000

Registered specialties

Obstetrics & Gynecology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207V00000X Licence 112784 (GA)

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Registry record

NPI: 1043159130
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Mar 2026
Record last updated: 15 Jun 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.