Individual
DR. PHILLIP LIMBAUGH LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1540 SPRING VALLEY DR, HUNTINGTON, WV 25704-9501
(304) 429-6741
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6212
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
23570
AL
2086S0122X
Plastic and Reconstructive Surgery Physician
35.113919
OH
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
42124
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000568865
ANTHEM
KY
05
—
2853050
—
OH
05
—
7100048660
—
KY
Enumeration date
04/10/2007
Last updated
07/07/2022
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