Individual
DR. CHARLES W LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 ST MARYS EPWORTH XING, STE. A500, NEWBURGH, IN 47630-9698
(812) 471-1591
(812) 471-6650
Mailing address
PO BOX 138, EVANSVILLE, IN 47701-0138
(812) 471-1591
(812) 471-6650
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
99025381A
IN
Other
Enumeration date
05/04/2006
Last updated
05/29/2019
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