Sturdivant, John Lacy
Sturdivant, John Lacy is an individual health care provider with primary practice located at 920 Doug White Dr Ste 510 , Myrtle Beach SC 29572-4183. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Sturdivant, John Lacy can be contacted via phone (843) 497-7772.Contact Information
Primary practice address
920 Doug White Dr Ste 510
Myrtle Beach SC 29572-4183
Phone: (843) 497-7772
Fax: (843) 848-7530
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 22001 | South Carolina |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 22001 | South Carolina |
Profile Details
| NPI number | 1700994662 |
|---|---|
| LBN Legal business name | Sturdivant, John Lacy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 29th, 2006 |
| Last updated | Jan 25th, 2022 - about 4 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 | 1700994662 | NPPES |
| South Carolina | MEDICAID | 220013 |
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