Lisa Pharis Allardice, MD
Individual provider Active NPI Pediatrics Physician · Lagrange, GA
NPI 1609800705 · NPPES record last updated Mar 29, 2011
Key facts
- NPI
- 1609800705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 038421 (GA)
- Practice address
- 205 Calumet Center Rd
Lagrange, GA 30241-6711 - Phone
- (706) 885-1961
- Fax
- (706) 885-1963
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038421 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Associates of Lagrange | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 038421 | GA | Yes |
Addresses
Primary practice location
205 Calumet Center Rd
Lagrange, GA 30241-6711
Mailing address
205 Calumet Center Rd
Lagrange, GA 30241-6711
Phone (706) 885-1961
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00612587C | Medicaid | GA |
Other providers in Lagrange, GA
- Soyoung Ahn
- Air Evac EMS, Inc.
- Olumide Adeniyl Ajayi
- Ezinne Akamiro
- Clarence Terrell Alford Jr.
- John Michael Allen
- Phylllis Allen
- Robin Alligood
- Joseph Morris Almand Jr.
- Abdallah Yousef Suleiman Almegdadi
All providers in Lagrange, GA · Pediatrics Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2011. 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.