Individual
KEVIN LACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
3675 J DEWEY GRAY CIRCLE, SUITE 300, AUGUSTA, GA 30909-1868
(706) 863-9595
(888) 745-3917
Mailing address
PO BOX 3726, AUGUSTA, GA 30914-3726
(706) 863-9595
(888) 745-3917
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4292
GA
363AS0400X
Surgical Physician Assistant
PA-1765
ID
363AS0400X
Surgical Physician Assistant
PA0000001669
TN
363AS0400X
Surgical Physician Assistant
PA1198
SC
363AS0400X
Surgical Physician Assistant
PA9106353
FL
Other
Enumeration date
03/02/2006
Last updated
03/10/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us