Provider Demographics
NPI:1811023617
Name:LACY, SARAH (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LACY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:PO BOX 0446 LOBBY J
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-327-0872
Mailing Address - Fax:
Practice Address - Street 1:990 W ANN ARBOR TRL STE 210
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-6202
Practice Address - Country:US
Practice Address - Phone:734-554-6004
Practice Address - Fax:734-455-5637
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301081675208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics