Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Warren Lackey, MD

Individual provider Family Medicine Physician · NPI 1144226291

Charles Warren Lackey, MD is an Emergency Medicine in Leadville, Colorado. Qualified in 1974, 52 years ago. Practices with Marillac Clinic, Inc, a 17-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
52
Licensed in
CO
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

822 W 4th St
Leadville, CO 80461-3861
Phone: (719) 486-1264
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 360 Peak One Dr Ste 100, Frisco, CO 80443-5948 — (970) 668-4040

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 19438 (CO)

Record details

NPI number1144226291
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 23, 2005
Last updated in NPPESMarch 2, 2023
Certification dateMarch 2, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 1974 (52 years in practice)
Group practice Marillac Clinic, Inc. — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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