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General NPI Number Information
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NPI Number | 1144781170
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Entity Type | Individual
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Provider Name | SEAN PAUL LACY DO
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Gender | Male
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Dates
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Enumeration Date | 03/31/2019
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 2790 CLAY EDWARDS DR STE 520
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3274
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Country | US
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Telephone | 816-221-6750
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Fax | 816-221-7280
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Provider Business Mailing Address
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Address Line | 3901 RAINBOW BLVD # MS 2027
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City | KANSAS CITY
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State | KS
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Zip | 66160-8500
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Country | US
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Telephone | 913-588-3974
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Fax | 913-588-6055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2025022428
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License Number State | MO
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