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Logan Lackey, M.D
NPI 1740506419 · on the registry since 2010 · sole proprietor
Practice
- Address
- 2055 S Fremont Ave
Suite 120
Springfield, MO 65804 - Phone
- (417) 820-2500
- Clinicians at this address
- 33
Registry record
- Primary taxonomy
- 2085R0202X
2085R0202X
- Also registered as
- 390200000X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-07-05
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 Missouri