Lackey, Betty Jane

Lackey, Betty Jane is an individual health care provider with primary practice located at 255 Enterprise Blvd Ste 101 , Greenville SC 29615-3530. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is her primary health care specialty. Lackey, Betty Jane can be contacted via phone (864) 454-8120.

Contact Information

Primary practice address
255 Enterprise Blvd Ste 101 Greenville SC 29615-3530
Phone: (864) 454-8120
Fax: (864) 454-8125
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X 36751 South Carolina
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207QH0002X 36751 South Carolina
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1043448509
LBN Legal business name Lackey, Betty Jane
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2009
Last updated Aug 8th, 2019 - about 5 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 1043448509 NPPES
South Carolina Other NPI # BLUE CHOICE
South Carolina MEDICAID 367515 BLUE CHOICE
South Carolina Other NPI # BLUE CHOICE
South Carolina Other P01624384 BLUE CHOICE
South Carolina Other NPI # BLUE CHOICE

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