Doctor Name: | DR. DENNIS MICHAEL LACEY |
NPI Number: | 1083696082 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 029704 |
Business Practice Address: | 1100 Johnson Ferry Rd Ne Bldg 1, Suite 425 Atlanta, GA - 30342 |
Business Phone Number: | 4042522666 |
Business Fax Number: | 4042520890 |
Mailing Address: | 1100 Johnson Ferry Rd Ne, Bldg 1, Suite 425 ATLANTA |
State: | GA |
Postal Code: | 30342 |
Phone Number: | 4042522666 |
Fax Number: | 4042520890 |
NPI Enumeration Date: | 11/16/2005 |
NPI Last Update Date: | 11/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 029704 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |