person
John Lackey, MD
Specialist in Pocatello, Idaho
NPI 1063456648

John Lackey is a Specialist based in Pocatello, ID. John Lackey practices in Pocatello, ID and has the professional credentials of MD. The NPI Number for John Lackey is 1063456648 and holds a License No. M3873 (Idaho).

The current practice location address for John Lackey is 500 S 11Th Ave, Pocatello, ID and can be reached out via phone at 208-232-3103 and via fax at 208-232-0756. You can also correspond with John Lackey through the mailing address at 700 CANYON DR, POCATELLO, ID - 83204-4840 (mailing address contact number: 208-234-1921).

Location: 500 S 11Th Ave, Pocatello, ID, 83204-4840
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Provider Profile Details
NPI Number
1063456648
Provider Name
John Lackey
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
500 S 11Th Ave, Pocatello, ID, 83204-4840
Phone Number
208-232-3103
Fax Number
208-232-0756
Provider Enumeration Date
06/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
002487500 05 ID
institution
Provider Business Practice Location Address Details
Address
500 S 11Th Ave
City
State
Zip
83201-4835
Phone Number
208-232-3103
Fax Number
208-232-0756
person
Provider Business Mailing Address Details
Address
500 S 11Th Ave
City
State
Zip
83201-4835
Phone Number
208-232-3103
Fax Number
208-232-0756
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
M3873 (Idaho)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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