Lackey, Herbert Lebron

Lackey, Herbert Lebron is an individual health care provider with primary practice located at 2370 N Ocoee St , Cleveland TN 37311-3850. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Lackey, Herbert Lebron can be contacted via phone (423) 479-6214.

Contact Information

Primary practice address
2370 N Ocoee St Cleveland TN 37311-3850
Phone: (423) 479-6214
Fax: (423) 614-4405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 24323 Tennessee

Profile Details

NPI number 1326046053
LBN Legal business name Lackey, Herbert Lebron
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Jun 15th, 2009 - about 16 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 1326046053 NPPES
Tennessee MEDICAID 3083638

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