Christopher Marcus Lack (NPI# 1427222454, PAC ID# 3375681133) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1427222454 |
| PAC ID by PECOS | 3375681133 |
| Professional Enrollment ID | I20091116000499 |
| Full Name | Christopher Marcus Lack |
| Organization Legal Name | WAKE FOREST BAPTIST IMAGING LLC |
| Address |
265 Executive Park Blvd Winston Salem NC 27103-1503 |
| Phone Number | 3367655722 |
| Gender | M |
| Graduation Year | 2008 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 3173681681 |
| Number of Group Practice Members | 54 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340047 | NORTH CAROLINA BAPTIST HOSPITAL |
| 340187 | DAVIE MEDICAL CENTER |
| 340039 | IREDELL MEMORIAL HOSPITAL INC |
| Address | Phone | Organization |
|---|---|---|
| 265 Executive Park Blvd, Winston Salem, NC 27103-1503 | 3367655722 | WAKE FOREST BAPTIST IMAGING LLC |
| Medical Ctr Blvd, Winston Salem, NC 27157-0001 | 3367162734 | WAKE FOREST UNIVERSITY HEALTH SCIENCES |
| Organization Legal Name | WAKE FOREST BAPTIST IMAGING LLC |
| Physicians | 52 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Caroline Chiles | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Tatum Simon Johnson | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Jao Jih Ou | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Anita Joyce Thomas | Nuclear Medicine | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Larkin Leo Selman | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Christopher Thomas Whitlow | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Matthew Olen Thompson | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Kelly Ann Brozzetti-cronin | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Daniel Walter Williams Iii | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Rafel F. Raphael Tappouni | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Street Address |
265 EXECUTIVE PARK BLVD |
| City | WINSTON SALEM |
| State | NC |
| Zip | 27103-1503 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Caroline Chiles | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Tatum Simon Johnson | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Jao Jih Ou | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Anita Joyce Thomas | Nuclear Medicine | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Larkin Leo Selman | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Christopher Thomas Whitlow | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Matthew Olen Thompson | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Kelly Ann Brozzetti-cronin | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Daniel Walter Williams Iii | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Rafel F. Raphael Tappouni | Diagnostic Radiology | Wake Forest Baptist Imaging LLC | 265 Executive Park Blvd, Winston Salem, NC 27103-1503 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Predrag V Gligorovic | Psychiatry | Wake Forest University Health Sciences | 791 Jonestown Rd, Wfbh Psychiatry Jonestown, Winston-salem, NC 27103-1252 |
| John G Spangler | Family Medicine | Wake Forest University Health Sciences | 791 Jonestown Rd, Wfbh Psychiatry Jonestown, Winston-salem, NC 27103-1252 |
| Sahil Munjal | Psychiatry | Wake Forest University Health Sciences | 791 Jonestown Rd, Wfbh Psychiatry Jonestown, Winston-salem, NC 27103-1252 |
| Stephen I Kramer | Psychiatry | Wake Forest University Health Sciences | 791 Jonestown Rd, Wfbh Psychiatry Jonestown, Winston-salem, NC 27103-1252 |
| Gayathri D Tadepalli | Psychiatry | Wake Forest University Health Sciences | 791 Jonestown Rd, Wfbh Psychiatry Jonestown, Winston-salem, NC 27103-1252 |
| Richard Patrick Smith | Psychiatry | Wake Forest University Health Sciences | 791 Jonestown Rd, Wfbh Psychiatry Jonestown, Winston-salem, NC 27103-1252 |
| James N Kimball | Psychiatry | Wake Forest University Health Sciences | 791 Jonestown Rd, Wfbh Psychiatry Jonestown, Winston-salem, NC 27103-1252 |
| Katherine Atala | Psychiatry | Wake Forest University Health Sciences | 791 Jonestown Rd, Wfbh Psychiatry Jonestown, Winston-salem, NC 27103-1252 |
| Heather Douglas | Psychiatry | Wake Forest University Health Sciences | 791 Jonestown Rd, Wfbh Psychiatry Jonestown, Winston-salem, NC 27103-1252 |
| Richard Adam Boiter | Psychiatry | Wake Forest University Health Sciences | 791 Jonestown Rd, Wfbh Psychiatry Jonestown, Winston-salem, NC 27103-1252 |
| Find all physicians in zip 27103 | |||
| City | WINSTON SALEM |
| Zip Code | 27103 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | WINSTON SALEM + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Christopher Marcus Lack.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.