Provider Demographics
NPI:1427436203
Name:CARTER, LACEY MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:LACEY
Middle Name:MARTIN
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:LACEY
Other - Middle Name:BRIE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:48 CROSS PARK CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605
Practice Address - Country:US
Practice Address - Phone:864-797-7440
Practice Address - Fax:864-797-7469
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC89564207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery