Individual
DR. VICTORIA DONOVAN LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-1198
(336) 716-4209
(336) 716-9916
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-4209
(336) 716-9916
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
9600226
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720005374
—
NC
05
—
8950529
—
NC
05
—
N00226
—
SC
Enumeration date
07/17/2006
Last updated
12/09/2022
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