Fernandes, Lactancio
Fernandes, Lactancio is an individual health care provider with primary practice located at 1107 Earl Frye Blvd Ste 3 , Amory MS 38821-5519. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Fernandes, Lactancio can be contacted via phone (662) 256-9590.Contact Information
Primary practice address
1107 Earl Frye Blvd Ste 3
Amory MS 38821-5519
Phone: (662) 256-9590
Fax: (662) 256-9599
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 14203 | Mississippi |
Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 14203 | Mississippi |
Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 14203 | Mississippi |
Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 14203 | Mississippi |
Profile Details
NPI number | 1942398409 |
---|---|
LBN Legal business name | Fernandes, Lactancio |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 10th, 2006 |
Last updated | Mar 4th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1942398409 | NPPES |
Mississippi | MEDICAID | 01578334 | |
Mississippi | Other | P00821834 |
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