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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KEVIN LACK, P.A.-C

Active

KEVIN LACK, P.A.-C is a Surgical Physician Assistant healthcare provider located in AUGUSTA, Georgia. NPI 1417924028 is currently active in the NPPES registry. Verify at CMS.

Surgical Physician Assistant · AUGUSTA, GA

Registration Details

NPI Number
1417924028
Provider Type
Individual
Gender
Male
NPI Issued
Mar 2, 2006 (20.431916055957 yrs)
Last Updated
Mar 10, 2025
Licenses
PA-1765 (ID)
PA1198 (SC)
PA0000001669 (TN)
PA9106353 (FL)
4292 (GA)

Practice Information

Address
3675 J DEWEY GRAY CIRCLE
SUITE 300
AUGUSTA, GA, 309091868
Browse GA providers · Browse ZIP 30909
Phone
7068639595
Fax
8887453917
Primary Specialty
Surgical Physician Assistant
363AS0400X
Additional Specialty
Surgical Physician Assistant
Additional Specialty
Surgical Physician Assistant
Additional Specialty
Surgical Physician Assistant
Additional Specialty
Surgical Physician Assistant

Other Surgical Physician Assistant Providers in AUGUSTA, GA

Name Credential NPI
JOHNNA W RUFFIN P.A.-C 1376510982
JANICE M MILLER P.A.-C 1447227053
CHARLES A GERTLER P.A.-C 1356318679
JEANINE LINEHAN-BURACK P.A.-C. 1336108141
DENA MARIE HAMMOND PA-C 1033168463
MR. FRANK ANDREW EBERHEART PA-C 1134172521
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.