| Roy Jareth Lackey, PA-C | |
|
Psc 819 Box 18, Fpo, AE 09645-0001 | |
| (314) 727-3606 | |
| Not Available |
| Full Name | Roy Jareth Lackey |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | Psc 819 Box 18, Fpo, Armed Forces Europe |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962169011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA62549 (California) | Primary |
| Entity Name | Cep America - California |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023063542 PECOS PAC ID: 6103739131 Enrollment ID: O20031106000520 |
| Entity Name | Temecula Valley Emergency Medical Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407845092 PECOS PAC ID: 0345206405 Enrollment ID: O20041209000758 |
| Mailing Address | Practice Location Address |
|---|---|
| Roy Jareth Lackey, PA-C 32863 Abana Ct, Temecula, CA 92592-9271 Ph: (843) 597-5477 | Roy Jareth Lackey, PA-C Psc 819 Box 18, Fpo, AE 09645-0001 Ph: (314) 727-3606 |
Mr. Cameron Keiji Tsuhako, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: Usnh, Fpo, AE 09589 Phone: 011-539-972258 |
Alejandra Diaz, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: Psc 819 Box 18, Fpo, AE 09645 Phone: 703-681-2369 |
Hannah Marie Mcgrath, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: Psc 817 Box 481, Fpo, AE 09622 Phone: 708-699-9976 |
Felix Iheanacho, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: Psc 836, Fpo, AE 09636 Phone: 314-624-4811 |
Mr. Ricky Alfred Varone, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: Psc 836, Box 357, Fpo, AE 09636 Phone: 011-390-95866298 |
James William Gilliam Ii, M.P.A.S., PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: Usns Mount Baker T-ae 34, Medical Department, Fpo, AE 09578 Phone: 732-866-7024 |
Vanessa Marie Pursel, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: Uss John C. Stennis (cvn-74), Unit 100175 Box 1, Fpo, AE 09512 Phone: 702-279-3061 |