Individual
DAVID LAWRENCE LACEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12368 STRATFORD DR, SUITE 300, CLIVE, IA 50325-8162
(515) 226-9810
(515) 226-8408
Mailing address
13338 LAKE SHORE DR, CLIVE, IA 50325-8740
(515) 254-0336
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
32479
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3189886
—
IA
Enumeration date
05/01/2006
Last updated
07/08/2007
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