Lisa Smart, DRIVER/OWNER
Individual provider Active NPI Driver · Pelham, GA
NPI 1114678323 · NPPES record last updated Jan 10, 2022
Key facts
- NPI
- 1114678323
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 560 Stage Coach Rd Lot 1
Pelham, GA 31779-4072 - Phone
- (229) 319-8815
- Fax
- (229) 683-3748
- NPI assigned
- Jan 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
560 Stage Coach Rd Lot 1
Pelham, GA 31779-4072
Mailing address
560 Stage Coach Rd Lot 1
Pelham, GA 31779-4072
Phone (229) 319-8815
Other names
- Lisa Brown
Other providers in Pelham, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.