Individual
DR. FELICIA S LACKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1351 STONEBRIDGE PKWY, BLDG 105, WATKINSVILLE, GA 30677-6037
(706) 769-3331
(706) 769-3360
Mailing address
2727 PACES FERRY ROAD, SUITE 1-1100 (ATTENTION DENISE), ATLANTA, GA 30339
(470) 271-3421
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
047612
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00857007A
—
GA
Enumeration date
03/21/2006
Last updated
06/13/2018
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