John Lackey, MD

Practice location

Address

500 S 11th Ave, Pocatello, ID 83201-4835

Phone

(208) 232-3103

Fax

(208) 232-0756

Mailing address

700 Canyon Dr, Pocatello, ID 83204-4840

Registered specialties

Registry record

NPI

1063456648

Entity type

Individual

Sex (as registered)

Male

NPI issued

15 Jun 2006

Record last updated

8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.