Evin Lake Guilliams, DO is a medicare enrolled "Neurological Surgery" physician in Ashland, Kentucky. His current practice location is
617 23rd St Ste 400, Ashland, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(606) 329-1770.
Evin Lake Guilliams is licensed to practice in Kentucky (license number TP273) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1497287734.
Physician's Profile
| Full Name | Evin Lake Guilliams |
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| Gender | Male |
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| Speciality | Neurological Surgery |
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| Location | 617 23rd St Ste 400, Ashland, Kentucky |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1497287734
- Provider Enumeration Date: 03/28/2017
- Last Update Date: 05/20/2025
Medicare PECOS Information:
- PECOS PAC ID: 0648543041
- Enrollment ID: I20240718003759
Medical Identifiers
Medical identifiers for Evin Lake Guilliams such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1497287734 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207T00000X | Neurological Surgery | OS21210 (Florida) | Secondary |
| 207T00000X | Neurological Surgery | TP273 (Kentucky) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Evin Lake Guilliams allows following entities to bill medicare on his behalf.
| Entity Name | Lyerly Baptist Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1851347801
PECOS PAC ID: 9830112226
Enrollment ID: O20060111001171 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Evin Lake Guilliams is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Evin Lake Guilliams, DO
Po Box 746647,
Atlanta, GA 30374-6647
Ph: (904) 388-6518 | Evin Lake Guilliams, DO
617 23rd St Ste 400,
Ashland, KY 41101-2880
Ph: (606) 329-1770 |
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