Grace Marie Lidl, MD

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

Practice address

301 Andrews Ave.
Lyster Army Health Clinic
Fort Rucker, AL 36362-5333

Phone

(334) 255-7040

Fax

(334) 255-7716

NPI assigned

Sep 4, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1710171673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ANDREWS AVE.",
            "address_2": "LYSTER ARMY HEALTH CLINIC",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "363625333",
            "telephone_number": "334-255-7040",
            "fax_number": "334-255-7716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ANDREWS AVE.",
            "address_2": "LYSTER ARMY HEALTH CLINIC",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "363625333",
            "telephone_number": "334-255-7040",
            "fax_number": "334-255-7716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDL",
        "first_name": "GRACE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Twyla Lee, LPN
• Lisa Lewis, RN
• Sheila Beth Lewis, SOCIAL SERVICE ASSIS
• Sheila M Lewis, NURSING ASSISTANT
• Jacob Michael Lezon
• Jessica Dawn Lindsey, RDN
• Kristie Marie Little, NURSING ASSISTANT
• Shanae Loiseau, HLTH PROMOTION TECH
• Carlos V Lopez Aquino, MD
• Lyster Army Health Clinic

• Military Health Care Provider in Fort Rucker, AL
• Providers in Fort Rucker, AL by specialty
• Military Health Care Provider in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.