Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB GRAY LACKEY, PA-C
ActiveJACOB GRAY LACKEY, PA-C is a Physician Assistant healthcare provider located in CLEMMONS, North Carolina. NPI 1699178731 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · CLEMMONS, NC
Registration Details
- NPI Number
- 1699178731
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 3, 2014 (11.854340490682 yrs)
- Last Updated
- Aug 18, 2021
- Licenses
-
0010-05288 (NC)001005288 (NC)
Practice Information
- Address
-
3163 GAMMON LNCLEMMONS, NC, 270129052Browse NC providers · Browse ZIP 27012
- Phone
- 3363105571
- Fax
- 3363105574
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Medical Physician Assistant
Other Physician Assistant Providers in CLEMMONS, NC
| Name | Credential | NPI |
|---|---|---|
| PAUL KENT DAVIS | PA-C | 1750384343 |
| MRS. DANIELLE MARGUERITE CARTER ADKINS | PA-C | 1992787501 |
| TERRY MICHAEL DEAKLE | PA | 1326028382 |
| CAMILLA ELIZABETH HELTON | PA | 1922070747 |
| MR. GLEN EDWARD COMBS | P.A. | 1235102211 |
| HUGH AVERY WHEELER | PA-C | 1497729230 |
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.