Provider Demographics
NPI:1245914894
Name:LAMEY CLINIC, LLC
Entity type:Organization
Organization Name:LAMEY CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:501-730-1676
Mailing Address - Street 1:523 HARKRIDER ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-5631
Mailing Address - Country:US
Mailing Address - Phone:501-514-8531
Mailing Address - Fax:501-358-6045
Practice Address - Street 1:523 HARKRIDER ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-5631
Practice Address - Country:US
Practice Address - Phone:501-514-8531
Practice Address - Fax:501-358-6045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty