| Jacob Gray Lackey, PA-C | |
|
3163 Gammon Ln, Clemmons, NC 27012-9052 | |
| (336) 310-5571 | |
| (336) 310-5574 |
| Full Name | Jacob Gray Lackey |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 10 Years |
| Location | 3163 Gammon Ln, Clemmons, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699178731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 0010-05288 (North Carolina) | Primary |
| 363AM0700X | Physician Assistant - Medical | 001005288 (North Carolina) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Watauga Medical Center | Boone, NC | Hospital |
| Charles A Cannon Jr Memorial Hospital | Linville, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Appalachian Regional Medical Associates Inc | 5799877817 | 85 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacob Gray Lackey, PA-C Po Box 601843, Charlotte, NC 28260-1843 Ph: () - | Jacob Gray Lackey, PA-C 3163 Gammon Ln, Clemmons, NC 27012-9052 Ph: (336) 310-5571 |
Carrie Hall Merritt, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 105 Stadium Oaks Dr, Clemmons, NC 27012 Phone: 336-766-0547 Fax: 366-766-0549 | |
Caroline W Mackellar, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2311 Lewisville Clemmons Rd, Clemmons, NC 27012 Phone: 336-713-0400 | |
Mrs. Jennifer Niland Kerley, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 7130 Village Medical Cir, Clemmons, NC 27012 Phone: 336-893-2420 Fax: 336-893-2431 | |
James A Mccaffrey, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 2311 Lewisville Clemmons Rd, Clemmons, NC 27012 Phone: 336-716-2255 | |
Allie Stugart Smith, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6301 Stadium Dr, Clemmons, NC 27012 Phone: 336-766-6473 Fax: 336-766-8909 | |
Alexandra Jane Talbert, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 5175 Old Clemmons School Rd, Clemmons, NC 27012 Phone: 336-718-3960 | |
Rebecca Faith Myers, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4136 Clemmons Rd, Clemmons, NC 27012 Phone: 336-893-3270 |