NPI age
17 years
Enumerated 2008-07-21
● Active
Type 1 · Individual
DR. Russell William Lake, MD
Lake is 1 of 18 family medicine providers in Richmond Hill and 1 of 5448 in Georgia.
Primary specialty
Family Medicine
Plus 1 subspecialty
Licensed in
GA, SC
2 states
Status
Active
No deactivations on record
Last NPPES update
2021-10-19
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 5448 active family medicine providers in Georgia.
NPI age
17 years
≈ at median (17 yr)
State licenses
2 states
Top 87% — 12% of peers are multi-state
Subspecialties
0
26% of peers hold subspecialties
NPI lifetime · 2008 → 2026
2008-07Enumerated in NPPES
2008
2026
Where they practice
Practice location
10055 Ford Avenue, Suite 3a
Richmond Hill, GA 31324
Mailing address
836 E. 65th Street, Suite 22
Savannah, GA 31405
Specialties
-
Family Medicine PrimaryFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 200480198D | |
| 05 (GA) | 003213522B |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.