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Lori Anne Tackman, MD
Pediatrics Physician in Supply, North Carolina
NPI 1497752968

Lori Anne Tackman is a Pediatrics Physician based in Charlotte, NC. Lori Anne Tackman practices in Supply, NC and has the professional credentials of MD. The NPI Number for Lori Anne Tackman is 1497752968 and holds a License No. 2000-00146 (North Carolina).

The current practice location address for Lori Anne Tackman is 20 Medical Campus Dr Nw Ste 205, Supply, NC and can be reached out via phone at 910-721-4400 and via fax at 910-721-4409.

Location: 20 Medical Campus Dr Nw Ste 205, Supply, NC, 28260-0447
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1497752968
Provider Name
Lori Anne Tackman
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
20 Medical Campus Dr Nw Ste 205, Supply, NC, 28260-0447
Phone Number
910-721-4400
Fax Number
910-721-4409
Provider Enumeration Date
06/30/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
126WX 01 NC BCBS
89126WX 05 NC
institution
Provider Business Practice Location Address Details
Address
20 Medical Campus Dr Nw Ste 205
City
Supply
State
North Carolina
Zip
28462
Phone Number
910-721-4400
Fax Number
910-721-4409
person
Provider Business Mailing Address Details
Address
20 Medical Campus Dr Nw Ste 205
City
Supply
State
North Carolina
Zip
28462
Phone Number
910-721-4400
Fax Number
910-721-4409
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Pediatrics
Speciality
-
Taxonomy
208000000X
License No.
2000-00146 (North Carolina)
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
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