Provider Demographics
NPI:1104595123
Name:KATHI LACOURT MD PLLC
Entity type:Organization
Organization Name:KATHI LACOURT MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:LACOURT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-675-8668
Mailing Address - Street 1:6501 E GREENWAY PKWY STE 103-648
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254
Mailing Address - Country:US
Mailing Address - Phone:602-675-8668
Mailing Address - Fax:
Practice Address - Street 1:6801 E GELDING DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-8525
Practice Address - Country:US
Practice Address - Phone:480-678-1414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty