Bruce Lackie (NPI# 1629189824, PAC ID# 4688621477) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL SOCIAL WORKER.
| Nation Provider ID (NPI) | 1629189824 |
| PAC ID by PECOS | 4688621477 |
| Professional Enrollment ID | I20070323000315 |
| Full Name | Bruce Lackie |
| Address |
56 Taylor Rd Orono ME 04473-3205 |
| Phone Number | 2079443982 |
| Gender | M |
| Credential | CSW |
| Graduation Year | 1971 |
| Primary Specialty | CLINICAL SOCIAL WORKER |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 56 Taylor Rd, Orono, ME 04473-3205 | 2079443982 |
| Street Address |
56 TAYLOR RD |
| City | ORONO |
| State | ME |
| Zip | 04473-3205 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joye M Jewell - Hill | Nurse Practitioner | Eastern Maine Medical Center | 84 Kelley Rd, Orono, ME 04473-3416 |
| Orville A Hartford | Dermatology | Penobscot Valley Dermatology, P.a. | 381 Main St, Orono, ME 04473-3446 |
| Faith Whalen | Dermatology | Penobscot Valley Dermatology, P.a. | 381 Main St, Orono, ME 04473-3446 |
| Linda L Mcdougall | Nurse Practitioner | Penobscot Valley Dermatology, P.a. | 381 Main St, Orono, ME 04473-3446 |
| Jaymie Fe P Panuncialman | Dermatology | Penobscot Valley Dermatology, P.a. | 381 Main St, Orono, ME 04473-3446 |
| Amy C Sim | Nurse Practitioner | Penobscot Valley Dermatology, P.a. | 381 Main St, Orono, ME 04473-3446 |
| Carolyn L Ellis | Dermatology | Penobscot Valley Dermatology, P.a. | 381 Main St, Orono, ME 04473-3446 |
| Samantha Mitchell | Nurse Practitioner | Penobscot Valley Dermatology, P.a. | 381 Main St, Orono, ME 04473-3446 |
| Holly L Haeberlein | Nurse Practitioner | Penobscot Valley Dermatology, P.a. | 381 Main St, Orono, ME 04473-3446 |
| Laurie E Yntema | Internal Medicine | Penobscot Community Health Center | 9 Alumni Dr, Orono, ME 04473-3479 |
| Find all physicians in zip 04473 | |||
| City | ORONO |
| Zip Code | 04473 |
| Specialty | CLINICAL SOCIAL WORKER |
| City + Specialty | ORONO + CLINICAL SOCIAL WORKER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.