Organization
HUGH L LACEY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUGH LAKE LACEY M.D. (PRESIDENT)
(417) 624-2111
Entity
Organization
Contact information
Practice address
1905 W32ND STREET, SUITE 306, JOPLIN, MO 64804-1512
(417) 624-2111
(417) 624-1551
Mailing address
PO BOX 2067, JOPLIN, MO 64804-2067
(417) 624-2111
(417) 624-1551
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R6N85
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760565048
INDIVIDUAL NPI
MO
Enumeration date
05/11/2010
Last updated
02/17/2012
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