Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 7821 | AL |
NPI | 1043260326 |
---|---|
Provider Name | Dr. Fritz A Lacour |
First Address | Loxley, AL 36551-2562 |
Second Address | Loxley, AL 36551-2562 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 14/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43508 | (05) | AL |
B64976 | (02) |