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1679529382
TIMOTHY C LACKEY
SAINT LOUIS, MO
NPI
1679529382
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: MO 103240)
Enumeration Date
2006-05-25
Last Update Date
2013-02-04
Business Address
-- TIMOTHY C LACKEY MD
3555 SUNSET OFFICE DR SUITE 101
SAINT LOUIS, MO 63127-1015
Phone number: 314-966-0252
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Mailing Address
-- TIMOTHY C LACKEY MD
3555 SUNSET OFFICE DR SUITE 107
SAINT LOUIS, MO 63127-1015
Phone number: 314-822-5914
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