Individual
SUSAN NORTHERN LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6401 POPLAR AVE STE 530, MEMPHIS, TN 38119-4840
(901) 767-9368
(901) 767-9496
Mailing address
1407 UNION AVE, STE 1401, MEMPHIS, TN 38104-3667
(901) 701-1777
(901) 701-1778
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
28143
TN
Other
Enumeration date
08/11/2006
Last updated
11/01/2019
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