Search › North Carolina › 363A00000X
Jacob Lackey, PA-C
NPI 1699178731 · on the registry since 2014
Practice
- Address
- 3163 Gammon Ln
Clemmons, NC 27012 - Phone
- (336) 310-5571
- Fax
- (336) 310-5574
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363AM0700X
- Licence states on file
- NC
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-08-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in North Carolina