John Lackey is a Specialist in Pocatello, Idaho. John Lackey practices all healthcare services and medical treatments related to Specialist. The NPI Number for John Lackey is 1063456648. The last update date is 2007-07-08.
John Lackey's current location address is 700 Canyon Dr, Pocatello, Idaho. You can contact this provider via phone number 2082341921. The mailing address for John Lackey is 700 Canyon Dr, Pocatello, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John Lackey |
|---|---|
| Address | 700 Canyon Dr, Pocatello, Idaho |
| Phone Number | 2082341921 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1063456648 |
|---|---|
| Provider Enumeration Date | 2006-06-15 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 700 Canyon Dr |
|---|---|
| City | Pocatello |
| State | Idaho (ID) |
| Post Code | 832044840 |
| Phone Number | 2082341921 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | M3873 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2487500 | ID | -- |
Post Comment/ Review Below
What is the John Lackey's unique identification number?
The John Lackey has been assigned the NPI (National Provider Identifier) Number 1063456648 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of John Lackey?
The John Lackey is situated at 700 Canyon Dr, in the city of Pocatello, state of ID, with the zip code 832044840.
What is John Lackey's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for John Lackey is Specialist, and the corresponding taxonomy classification code for this specialized field is 174400000X.
When did the John Lackey receive its 1063456648?
The John Lackey was issued its 1063456648 on 2006-06-15, which is the date when the organization was assigned this unique identifier.
When was the information regarding John Lackey most recently updated?
The details pertaining to the John Lackey, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.