Individual
KEITH JAMES LACOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0438
Mailing address
PO BOX 918025, ORLANDO, GA 32891-8025
(352) 265-0438
(706) 660-2685
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
001963
GA
2085R0202X
Diagnostic Radiology Physician
Primary
ME109906
FL
Other
Enumeration date
04/16/2007
Last updated
01/05/2021
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