Individual
MR. ROBERT JORDAN LAKKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3269 N STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(928) 681-8577
Mailing address
PO BOX 3648, COEUR D ALENE, ID 83816-2522
(208) 292-0292
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20300
MT
207Q00000X
Family Medicine Physician
Primary
O-0886
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O-0886
ID STATE LICENSE
ID
Enumeration date
09/03/2009
Last updated
09/11/2025
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