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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