Individual
DR. THOMAS KEVIN LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3804 RAINBOW DR, RAINBOW CITY, AL 35906
(256) 952-2200
(256) 952-2202
Mailing address
3804 RAINBOW DR, RAINBOW CITY, AL 35906-3051
(256) 952-2200
(256) 952-2202
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
21928
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009960110
—
AL
01
—
051502368
BLUE CROSS BLUE SHIELD
AL
Enumeration date
11/18/2005
Last updated
06/21/2018
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