Individual
ROBERT L LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
7 VANDERBILT PARK DR, ASHEVILLE, NC 28803-1700
(828) 255-7776
(282) 274-5134
Mailing address
PO BOX 602811, CHARLOTTE, NC 28260-2811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-05849
NC
363AS0400X
Surgical Physician Assistant
Primary
0010-05849
NC
363AS0400X
Surgical Physician Assistant
742
GA
Other
Enumeration date
09/13/2006
Last updated
12/29/2015
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