Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 19327 | MS |
NPI | 1013068469 |
---|---|
Provider Name | Dr. Pamela Lacy |
First Address | Amory, MS 38821-5507 |
Second Address | Amory, MS 38821-5507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2007 |
Last Update Date | 02/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02225870 | (05) | MS |