Staley, Homer Lee
Staley, Homer Lee is an sole proprietor health care provider with primary practice located at 104 N Locust Ave , Lawrenceburg TN 38464-3734. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Staley, Homer Lee can be contacted via phone (931) 762-6476.Contact Information
Primary practice address
104 N Locust Ave
Lawrenceburg TN 38464-3734
Phone: (931) 762-6476
Fax: (931) 762-1841
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD008952 | Tennessee |
Profile Details
| NPI number | 1609886936 |
|---|---|
| LBN Legal business name | Staley, Homer Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1609886936 | NPPES |
| Tennessee | MEDICAID | 3170118 |
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