Philip C. Lackey M.D.

NPI 1083690325 - Internal Medicine - 207RI0200X

NPI Details
NPI 1083690325
Gender Male
Enumeration Date 12/19/2005
Last Updated 03/17/2015
Entity Type Individual
Active Over 10 years ago
Practice Location
4539 HEDGEMORE DR
SUITE 100
CHARLOTTE NC, 28209-3276, US
Phone (704) 331-9669
Fax (704) 331-0736
Business Location
PO BOX 601888
CHARLOTTE NC, 28260-1888, US
Phone (704) 331-9669
Fax (704) 331-0736
Toxanomy
Taxonomy Code 207RI0200X
License State North Carolina
License Number 96-00341
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According to our database, Philip C. Lackey M.D. NPI is 1083690325, taxonomy code is 207RI0200X and license number is 96-00341, license state is located at North Carolina. Philip C. Lackey M.D. physically located at 4539 Hedgemore Dr, Charlotte NC, 28209-3276. NPI Number Philip C. Lackey M.D. has the Individual type.

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1083690325 NPI number is provided on an as is basis without warranty of any kind. 1083690325 is maintained by the National Plan & Provider Enumeration System. The contents of Philip C. Lackey M.D. are for informational purposes only.