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Organization
NICOLE LACKEY DILLON, MD, INC
Active
Organization
NICOLE LACKEY DILLON, MD, INC
Active
Other names
Grayson Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE LACKEY DILLON M.D. (PRESIDENT)
(304) 752-9290
Entity
Organization
Contact information
Practice address
77 HOSPITAL DR, DOCTORS PARK SUITE D, LOGAN, WV 25601-3451
(304) 752-9290
Mailing address
77 HOSPITAL DR STE D, LOGAN, WV 25601-3451
(304) 752-9290
(304) 896-8682
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21324
WV
Other
Enumeration date
08/07/2012
Last updated
08/18/2022
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