Christopher I Lacy MD

NPI 1073590295 - Radiology - 2085R0202X

NPI Details
NPI 1073590295
Gender Male
Enumeration Date 12/29/2005
Last Updated 07/09/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
11 UPPER RIVERDALE RD SW
RIVERDALE GA, 30274-2615, US
Phone (770) 991-8000
Fax
Business Location
PO BOX 100041
KENNESAW GA, 30156-9241, US
Phone (770) 779-2178
Fax
Toxanomy
Taxonomy Code 2085R0202X
License State Georgia
License Number 045865
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According to our database, Christopher I Lacy MD NPI is 1073590295, taxonomy code is 2085R0202X and license number is 045865, license state is located at Georgia. Christopher I Lacy MD physically located at 11 Upper Riverdale Rd Sw, Riverdale GA, 30274-2615. NPI Number Christopher I Lacy MD has the Individual type.

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1073590295 NPI number is provided on an as is basis without warranty of any kind. 1073590295 is maintained by the National Plan & Provider Enumeration System. The contents of Christopher I Lacy MD are for informational purposes only.