Individual
DANIEL LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
660 S EUCLID AVE, CAMPUS BOX 8072, SAINT LOUIS, MO 63110-1010
(314) 362-8971
Mailing address
660 S EUCLID AVE, CAMPUS BOX 8072, SAINT LOUIS, MO 63110-1010
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2014017175
MO
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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