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General NPI Number Information
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NPI Number | 1891865952
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Entity Type | Organization
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Legal Business Name | CHEST MEDICINE ASSOCIATES P.S.C.
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 4606 GREENWOOD RD
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City | LOUISVILLE
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State | KY
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Zip | 40258-3726
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Country | US
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Telephone | 502-937-2209
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Fax | 502-933-8714
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Provider Business Mailing Address
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Address Line | 3430 NEWBURG RD SUITE 150
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City | LOUISVILLE
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State | KY
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Zip | 40218-2497
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Country | US
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Telephone | 502-238-3178
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Fax | 502-238-3653
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM O. LACY
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Credential | M.D.
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Telephone | 502-454-0269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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