Provider Demographics
NPI:1225127897
Name:LACY, STEVEN T (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:T
Last Name:LACY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ELM AVE.
Mailing Address - Street 2:MID UPPER CAPE COMMUNITY HEALTH CENTER
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-778-5420
Mailing Address - Fax:508-778-8747
Practice Address - Street 1:30 ELM AVE.
Practice Address - Street 2:MID UPPER CAPE COMMUNITY HEALTH CENTER
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5547
Practice Address - Country:US
Practice Address - Phone:508-778-5420
Practice Address - Fax:508-778-8747
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52901207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine