LISA ILSON (NPI# 1043718471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043718471 |
| Entity Type | Individual |
| Full Name | LISA ILSON |
| Practice Address |
950 Indian Trail Lilburn Rd Nw Ste 5d Lilburn GA 30047-6870 |
| Practice Telephone | 4705452131 |
| Mailing Telephone | 4705452131 |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2018-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
58124 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | REGISTRY | 58124 | 01 |
| Street Address |
950 INDIAN TRAIL LILBURN RD NW STE 5D |
| City | LILBURN |
| State | GA |
| Zip Code | 30047-6870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750861217 | Latrina S Walden | Nurse Practitioner | 887 Ryan Lane, Lilburn, GA 30047 | 2018-08-15 |
| 1811483928 | Olivia Oyegunle | Optometrist | 4153 Lawrenceville Hwy Nw Ste 5, Lilburn, GA 30047 | 2018-07-02 |
| 1932619285 | Mpm Creative, LLC | Speech-Language Pathologist | 1560 Hewatt Rd, Lilburn, GA 30047 | 2017-10-01 |
| 1528515186 | Smith Dental Care of Lilburn, Inc. | Dentist | 3100 Five Forks Trickham Rd Suite 201, Lilburn, GA 30047 | 2016-09-01 |
| 1891143244 | Choices Behavioral Alternatives | Counselor | 4037 Darling Court, Suite B, Lilburn, GA 30047 | 2016-05-26 |
| 1235595687 | Georgia Dental Associates | Clinic/Center | 3100 Five Forks Trickum Road Suite 201, Lilburn, GA 30047 | 2016-01-14 |
| 1912382144 | Sangeetha Asokan | Dentist | 609, Beaver Ruin Road, Tebo Dental for Kids, Lilburn, GA 30047 | 2015-07-29 |
| 1467836403 | Pamela Neal | Registered Nurse | 3315 Landingview Ct, Lilburn, GA 30047 | 2015-07-18 |
| 1699172452 | Josie Kou, Kulah Curran | Registered Nurse | 3708 Tamer Ln, Lilburn, GA 30047 | 2014-11-21 |
| 1184039380 | Cheryl Lee | Chiropractor | 5014 Stone Mountain Hwy, Suite C, Lilburn, GA 30047 | 2014-06-25 |
| Find all providers in zip 30047 | ||||
| Taxonomy Code | 2085U0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Ultrasound |
| A Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. [Note: In medical practice, Diagnostic Ultrasound is part of the scope of training and practice of a Diagnostic Radiologists – see Taxonomy Code 2085R0202X.] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033738570 | Angel Thomas | Radiology | 21 Lake Shore Blvd, Port Wentworth, GA 31407-3612 | 2020-04-14 |
| 1699264093 | Lisa Iacofano | Radiology | 275 Carpenter Dr Ste 209, Atlanta, GA 30328-4910 | 2018-05-02 |
| 1477704831 | South Atlanta Radiology Associates- Griffin | Radiology | 680a S 9th St, Griffin, GA 30224-4216 | 2008-10-03 |
| 1922264886 | Radiological Analysis & Digitization of X-rays | Radiology | 6810 Roswell Rd Ne, Suite 1-b, Sandy Springs, GA 30328-2445 | 2008-07-31 |
| 1578692570 | Ronald Wolf Harris | Radiology | 1914 Robinhood Rd, Albany, GA 31707-3126 | 2007-03-05 |
| 1437508140 | Uzoma Igboagi | Radiology | 1120 15th St, Augusta, GA 30912-0004 | 2016-06-03 |
| 1821341272 | Commerce Radiology, LLC | Radiology | 70 Medical Center Dr, Commerce, GA 30529-1078 | 2012-10-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.