Organization
LAWRENCEBURG FAMILY PRACTICE ASSOCIATES, PC
Active
Other names
Homer L. Staley, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOMER L STALEY M.D. (PRESIDENT)
(931) 762-6476
Entity
Organization
Contact information
Practice address
104 N LOCUST AVE, LAWRENCEBURG, TN 38464-3734
(931) 762-6476
(931) 762-1841
Mailing address
104 N LOCUST AVE, LAWRENCEBURG, TN 38464-3734
(931) 762-6476
(931) 762-1841
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD008952
TN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
MD008952
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3170118
—
TN
Enumeration date
06/05/2009
Last updated
06/05/2009
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