Individual
DR. JOANNE L. LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
108 FRONTENAC FRST, SAINT LOUIS, MO 63131-3218
(314) 497-2368
Mailing address
108 FRONTENAC FRST, SAINT LOUIS, MO 63131-3218
(314) 497-2368
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
2004001646
MO
2085R0202X
Diagnostic Radiology Physician
Primary
2004001646
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209014307
—
MO
Enumeration date
10/03/2006
Last updated
11/09/2022
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