# LAWRENCEBURG FAMILY PRACTICE ASSOCIATES, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Homer L. Staley, MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619103579
- **Authorized official:** DR. HOMER L STALEY M.D. (PRESIDENT)
- **Authorized official phone:** (931) 762-6476

## Contact information

- **Practice address:** 104 N LOCUST AVE, LAWRENCEBURG, TN 38464-3734
- **Practice address phone:** (931) 762-6476
- **Practice address fax:** (931) 762-1841
- **Mailing address:** 104 N LOCUST AVE, LAWRENCEBURG, TN 38464-3734
- **Mailing address phone:** (931) 762-6476
- **Mailing address fax:** (931) 762-1841

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD008952 | TN | Yes |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | MD008952 | TN | — |

## Other

- **Enumeration date:** 06/05/2009
- **Last updated:** 06/05/2009