Lacey, Stuart R

Lacey, Stuart R is an individual health care provider with primary practice located at 5310 W Thunderbird Rd Suite110, Glendale AZ 85306-4706. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as his primary health care specialty. Lacey, Stuart R can be contacted via phone (602) 865-4065.

Contact Information

Primary practice address
5310 W Thunderbird Rd Suite110 Glendale AZ 85306-4706
Phone: (602) 865-4065
Fax: (602) 865-6100
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 31590 Arizona
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X MD155068 Oregon

Profile Details

NPI number 1831171107
LBN Legal business name Lacey, Stuart R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2005
Last updated Feb 4th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831171107 NPPES
Arizona MEDICAID 788763

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