Lack, Kevin
Lack, Kevin is an individual health care provider with primary practice located at 3675 J Dewey Gray Circle Suite 300, Augusta GA 30909-1868. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Lack, Kevin can be contacted via phone (706) 863-9595.Contact Information
Primary practice address
3675 J Dewey Gray Circle Suite 300
Augusta GA 30909-1868
Phone: (706) 863-9595
Fax: (888) 745-3917
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA-1765 | Idaho |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA1198 | South Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA0000001669 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA9106353 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 4292 | Georgia |
Profile Details
| NPI number | 1417924028 |
|---|---|
| LBN Legal business name | Lack, Kevin |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 2nd, 2006 |
| Last updated | Jun 3rd, 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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