Dr JOHN M LACKEY is a male medical professional, specializing in Obstetrics/gynecology. He graduated in 1968.
NOT TSOO GAH NEE INDIAN HEALTH
MISSION RD
FORT HALL
ID
832030717
Tel: 2082385400
| Npi | 1063456648 |
| Pac Id | 6103958988 |
| Professional Enrollment Id | I20100714000251 |
| Last Name | LACKEY |
| First Name | JOHN |
| Middle Name | M |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 1968 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Secondary Specialty 1 | GENERAL PRACTICE |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | GENERAL PRACTICE |
| Organization Legal Name | NOT TSOO GAH NEE INDIAN HEALTH |
| Group Practice Pac Id | 7012936578 |
| Number Of Group Practice Members | 5 |
| Line 1 Street Address | MISSION RD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | FORT HALL |
| State | ID |
| Zip Code | 832030717 |
| Phone Number | 2082385400 |
| Hospital Affiliation Ccn 1 | 130028 |
| Hospital Affiliation Lbn 1 | PORTNEUF MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | 131325 |
| Hospital Affiliation Lbn 2 | BINGHAM MEMORIAL HOSPITAL |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
| Hospital Affiliation Ccn 4 | |
| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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