Lackey, Victoria Donovan
Lackey, Victoria Donovan is an individual health care provider with primary practice located at Medical Center Blvd , Winston Salem NC 27157-1198. She recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as her primary health care specialty. Lackey, Victoria Donovan can be contacted via phone (336) 716-4209.Contact Information
Primary practice address
Medical Center Blvd
Winston Salem NC 27157-1198
Phone: (336) 716-4209
Fax: (336) 716-9916
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 9600226 | North Carolina |
Profile Details
| NPI number | 1720005374 |
|---|---|
| LBN Legal business name | Lackey, Victoria Donovan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Dec 9th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720005374 | NPPES |
| North Carolina | MEDICAID | 1720005374 | |
| North Carolina | MEDICAID | N00226 | |
| North Carolina | MEDICAID | 8950529 |
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