Organization
MORE 901 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN NORTHERN LACY MD (OWNER MD)
(901) 701-1777
Entity
Organization
Contact information
Practice address
1407 UNION AVE STE 1401, MEMPHIS, TN 38104-3667
(901) 701-1777
(901) 701-1778
Mailing address
1407 UNION AVE STE 1401, MEMPHIS, TN 38104-3667
(901) 701-1777
(901) 701-1778
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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