Individual
ANTHONY N LACKEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
420 W MAGNETIC ST, SUITE ER, MARQUETTE, MI 49855-2711
(888) 674-0854
(906) 225-3370
Mailing address
PO BOX 220, MARQUETTE, MI 49855-0220
(888) 674-0854
(906) 225-3370
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003024
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601003024
MICHIGAN LICENSE NUMBER
MI
Enumeration date
11/29/2005
Last updated
07/08/2007
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