| Lacy Williams, Llc | |
|
545 County Road Hq Marquette MI 49855-8855 | |
| (906) 273-0072 | |
| Not Available |
| Full Name | Lacy Williams, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 545 County Road Hq, Marquette, Michigan |
| Authorized Official Name and Position | Lacy Williams (OWNER/ORGANIZER) |
| Authorized Official Contact | 9063623701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lacy Williams, Llc 124 Wintergreen Trl Marquette MI 49855-9072 Ph: (906) 362-3701 | Lacy Williams, Llc 545 County Road Hq Marquette MI 49855-8855 Ph: (906) 273-0072 |
| NPI Number | 1306555693 |
|---|---|
| Provider Enumeration Date | 11/16/2022 |
| Last Update Date | 11/16/2022 |
| Medicare PECOS PAC ID | 5698145498 |
|---|---|
| Medicare Enrollment ID | O20230111001786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306555693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Lacy R Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881316065 PECOS PAC ID: 8325414378 Enrollment ID: I20221017002972 |
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