Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JOHN LACKEY, MD
ActiveSpecialist · POCATELLO, ID
Registration Details
- NPI Number
- 1063456648
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 15, 2006 (19.88095105834 yrs)
- Last Updated
- Jul 8, 2007
- License
-
M3873 (ID)
Practice Information
- Address
-
500 S 11TH AVEPOCATELLO, ID, 832014835Browse ID providers · Browse ZIP 83201
- Phone
- 2082323103
- Fax
- 2082320756
- Primary Specialty
-
Specialist
174400000X
Other Specialist Providers in POCATELLO, ID
| Name | Credential | NPI |
|---|---|---|
| DR. ANANDA WALALIYADDA | M.D. | 1497747703 |
| MR. DOUGLAS P NORMAN | M.D. | 1568499226 |
| JAMIE KAE COBBLEY | OTR/L | 1033396049 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.