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Individual
STEVEN KENNETH LACKEY
Active
Individual
STEVEN KENNETH LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31855
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-70268
UNITED HEALTHCARE
—
01
—
03-0455058
HEALTHCARE SAVINGS
—
01
—
080191010
RR MEDICARE
—
01
—
354567600
OWCP
—
01
—
43889
MEDCOST
—
01
—
50512
BCBS NC
—
05
—
7950512
—
NC
01
—
N31855
SC MEDICAID
—
01
—
NCI531A
MEDICARE PTAN
NC
01
—
P01413618
RR MEDICARE
NC
Enumeration date
02/27/2006
Last updated
04/01/2021
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