Dillon, Nicole Lackey

Dillon, Nicole Lackey is an individual health care provider with primary practice located at 77 Hospital Dr Ste D , Logan WV 25601-3451. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Dillon, Nicole Lackey can be contacted via phone (304) 752-9290.

Contact Information

Primary practice address
77 Hospital Dr Ste D Logan WV 25601-3451
Phone: (304) 752-9290
Fax: (304) 896-8682
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 39860 Kentucky
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 21324 West Virginia

Profile Details

NPI number 1730118431
LBN Legal business name Dillon, Nicole Lackey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Aug 18th, 2022 - about 2 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 1730118431 NPPES
West Virginia MEDICAID 1810172000

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