Lacy, Michael R
Lacy, Michael R is an individual health care provider with primary practice located at 1129 Hale Rd , Memphis TN 38116-6373. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Lacy, Michael R can be contacted via phone (901) 396-0390.Contact Information
Primary practice address
1129 Hale Rd
Memphis TN 38116-6373
Phone: (901) 396-0390
Fax: (901) 396-8151
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD3423 | Tennessee |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD16953 | Mississippi |
Profile Details
| NPI number | 1982691465 |
|---|---|
| LBN Legal business name | Lacy, Michael R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982691465 | NPPES |
| Tennessee | MEDICAID | 3898280 |
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