Chastain, Stephen Lackey
Chastain, Stephen Lackey is an sole proprietor health care provider with primary practice located at 5850 Se Community Dr , Stuart FL 34997-6420. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Chastain, Stephen Lackey can be contacted via phone (772) 324-3500.Contact Information
Primary practice address
5850 Se Community Dr
Stuart FL 34997-6420
Phone: (772) 324-3500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 00014657 | Alabama |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 33627 | South Carolina |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | ME114042 | Florida |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME114042 | Florida |
Profile Details
| NPI number | 1194784256 |
|---|---|
| LBN Legal business name | Chastain, Stephen Lackey |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 18th, 2006 |
| Last updated | May 9th, 2013 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194784256 | NPPES |
| Alabama | MEDICAID | 00083765 | |
| Alabama | MEDICAID | 336274 | |
| Alabama | Other | 51083765 |
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