Individual
DR. JONATHAN E LACKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 THOMAS LN STE 3G, COLUMBUS, OH 43214-1419
(614) 788-2870
(614) 533-0177
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35.140970
OH
208800000X
Urology Physician
99-72
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340020617
RAILROAD MEDICARE
NM
05
—
Z3796
—
NM
Enumeration date
07/12/2006
Last updated
08/07/2025
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