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Individual

DR. HOMER LEON LASSITER JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
405 BELCHER ST, CENTREVILLE, AL 35042-2946
(205) 926-2992
(205) 316-7675
Mailing address
405 BELCHER ST, CENTREVILLE, AL 35042-2946
(205) 926-2992
(205) 316-7675

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22263
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009996800
AL
05
150273
AL
Enumeration date
06/27/2006
Last updated
09/16/2024
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