Provider Demographics
NPI:1104230937
Name:HONEYCUTT, LACEY J (OD)
Entity type:Individual
Prefix:DR
First Name:LACEY
Middle Name:J
Last Name:HONEYCUTT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 VICTORIA AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-2210
Mailing Address - Country:US
Mailing Address - Phone:719-631-4110
Mailing Address - Fax:
Practice Address - Street 1:216 VICTORIA AVE
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-2210
Practice Address - Country:US
Practice Address - Phone:719-631-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3277152W00000X
TX8437T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist