Lack, Michael D
Lack, Michael D is an individual health care provider with primary practice located at 4334 E Highland Dr , Jonesboro AR 72401-6621. He recently has only one registered license in Allopathic & Osteopathic Physicians / Occupational Medicine, which is considered as his primary health care specialty. Lack, Michael D can be contacted via phone (870) 802-0012.Contact Information
Primary practice address
4334 E Highland Dr
Jonesboro AR 72401-6621
Phone: (870) 802-0012
Fax: (870) 972-5140
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Occupational Medicine | 2083X0100X | C5420 | Arkansas |
Profile Details
| NPI number | 1477515294 |
|---|---|
| LBN Legal business name | Lack, Michael D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1477515294 | NPPES |
| Arkansas | Other | 03100011900 | QUALCHOICE |
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