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JACOB GRAY LACKEY PA-C
PA-C
Physician Assistant
NPI: 1699178731IndividualAccepts Medicare
Specialties, Licenses & Credentials
Physician AssistantPrimary
Physician Assistant
Code: 363A00000X
0010-05288(NC)
Medical Physician Assistant
Physician Assistant — Medical
Code: 363AM0700X
001005288(NC)
Education
OTHER
Class of 2014
Contact & Hours
- Address
- 3163 GAMMON LN
CLEMMONS, NC 27012 - Phone
- (336) 310-5571
Quick Facts
- NPI
- 1699178731
- Entity Type
- Individual
- Gender
- Male
- Medicare
- Accepted
- Specialties
- 2
- Locations
- 1
- Years in Practice
- 12
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