Miller, Lisa Dawn

Miller, Lisa Dawn is an sole proprietor health care provider with primary practice located at 4152 Baker St Ne , Covington GA 30014-1404. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Miller, Lisa Dawn can be contacted via phone (770) 788-1077.

Contact Information

Primary practice address
4152 Baker St Ne Covington GA 30014-1404
Phone: (770) 788-1077
Fax: (770) 788-0768
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 038874 Georgia

Profile Details

NPI number 1801954458
LBN Legal business name Miller, Lisa Dawn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 5th, 2006
Last updated Sep 7th, 2011 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1801954458 NPPES
Georgia MEDICAID 00618945D
Georgia Other 00512
Georgia MEDICAID 00618945E

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