Lackey, Charles Warren

Lackey, Charles Warren is an individual health care provider with primary practice located at 822 W 4Th St , Leadville CO 80461-3861. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Lackey, Charles Warren can be contacted via phone (719) 486-1264.

Contact Information

Primary practice address
822 W 4Th St Leadville CO 80461-3861
Phone: (719) 486-1264
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 19438 Colorado

Profile Details

NPI number 1144226291
LBN Legal business name Lackey, Charles Warren
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Mar 2nd, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144226291 NPPES
Colorado MEDICAID 01194380

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