Lidell, John Mark
Lidell, John Mark is an individual health care provider with primary practice located at 101 Regency Park Dr Ste 110 , Mcdonough GA 30253-7076. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Lidell, John Mark can be contacted via phone (404) 996-0126.Contact Information
Primary practice address
101 Regency Park Dr Ste 110
Mcdonough GA 30253-7076
Phone: (404) 996-0126
Fax: (678) 432-2626
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 002952 | Georgia |
Profile Details
| NPI number | 1962487538 |
|---|---|
| LBN Legal business name | Lidell, John Mark |
| Credentials | M.M.SC. , PA-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 7th, 2005 |
| Last updated | Oct 27th, 2021 - about 4 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.
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