Provider Demographics
NPI:1255794186
Name:ARMSTRONG, LACEY JUNE (DO)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:JUNE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LACEY
Other - Middle Name:J
Other - Last Name:EAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:300 SINGLETON RIDGE ROAD
Mailing Address - Street 2:ATTENTION PATIENT ACCOUNTING
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9142
Mailing Address - Country:US
Mailing Address - Phone:843-234-6946
Mailing Address - Fax:
Practice Address - Street 1:2376 CYPRESS CIR, STE 200
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8994
Practice Address - Country:US
Practice Address - Phone:843-347-7216
Practice Address - Fax:843-347-7218
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008437207V00000X
SC83127207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC831274Medicaid