Provider Demographics
NPI:1780562173
Name:MOORE, LAKIM S SR
Entity type:Individual
Prefix:MR
First Name:LAKIM
Middle Name:S
Last Name:MOORE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 CLIFFORD AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-2300
Mailing Address - Country:US
Mailing Address - Phone:330-918-4687
Mailing Address - Fax:
Practice Address - Street 1:832 CLIFFORD AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-2300
Practice Address - Country:US
Practice Address - Phone:330-918-4687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care