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Individual

DR. GREGORY LAMONT LACY II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
800 HOWARD AVE, NEW HAVEN, CT 06519-1369
(203) 785-2815
(203) 785-4043
Mailing address
1990 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 868-9300
(985) 851-0053

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
15489R
LA
208800000X
Urology Physician
Primary
71573
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2336495
LA
Enumeration date
05/15/2006
Last updated
07/05/2022
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