LIZA DE OLAZO BANAAG, M. D., P. A. (NPI# 1558497040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558497040 |
| Entity Type | Organization |
| Organization Name | LIZA DE OLAZO BANAAG, M. D., P. A. |
| Practice Address |
965 J K Avent Dr Suite 100-a Grenada MS 38901-5045 |
| Mailing Address |
Po Box 2329 Grenada MS 38902-2329 |
| Practice Telephone | 6622277446 |
| Mailing Telephone | 8326465492 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-01-25 |
| Authorized Official Name | DR. LIZA DE OLAZO BANAAG (OWNER) |
| Authorized Official Telephone | 8326465492 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0011X |
Preventive Medicine Specialization: Undersea and Hyperbaric Medicine |
19748 | MS | Allopathic & Osteopathic Physicians |
| Street Address |
965 J K AVENT DR SUITE 100-A |
| City | GRENADA |
| State | MS |
| Zip Code | 38901-5045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912928086 | Justice Aaron Gondwe | Internal Medicine | 965 J K Avent Dr, Suite 106, Grenada, MS 38901-5045 | 2006-07-22 |
| 1144478512 | Grenada Adult Healthcare Clinic PC. | Clinic/Center | 965 J K Avent Dr, Suite 106, Grenada, MS 38901-5045 | 2008-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902435118 | The Mane Physician | Prosthetic/Orthotic Supplier | 94 Spain Drive, Grenada, MS 38901 | 2020-04-08 |
| 1942842166 | Sylvia C Bass | Technician | 813 Union Street, Grenada, MS 38901 | 2019-10-09 |
| 1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
| 1073912762 | John Thomas Mcree I | Counselor | 2026 Commerce St Ste 8e, Grenada, MS 38901 | 2014-08-19 |
| 1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
| 1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
| 1518256460 | Mercy Hospice LLC | Hospice Care, Community Based | 1410 Wooded Drive, Grenada, MS 38901 | 2011-03-31 |
| 1215256318 | Della Lea Welsh | Speech-Language Pathologist | 1321 Dd Sunset Dr., Grenada, MS 38901 | 2010-05-28 |
| 1750514543 | Family Health Care Clinic, Inc. | Clinic/Center | 1102 Telegraph St, Grenada, MS 38901 | 2009-08-27 |
| 1033384771 | Jason K Bennett | Pharmacist | 140 Shadow Wood Cv, Grenada, MS 38901 | 2008-04-24 |
| Find all providers in zip 38901 | ||||
| Taxonomy Code | 2083P0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Undersea and Hyperbaric Medicine |
| A specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide poisoning, gas gangrene, non-healing wounds, tissue damage from radiation and burns and bone infections. This specialist also serves as consultant to other physicians in all aspects of hyperbaric chamber operations and assesses risks and applies appropriate standards to prevent disease and disability in divers and other persons working in altered atmospheric conditions. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245622562 | Healogics Specialty Physicians of Mississippi, LLC | Preventive Medicine | 54 Sergeant Prentiss Dr, Natchez, MS 39120-4726 | 2015-02-24 |
| 1598017196 | South Central Clinics, Inc | Preventive Medicine | 1220 Jefferson St, Laurel, MS 39440-4355 | 2012-10-05 |
| 1235404377 | Delta Wound Care Pllc | Preventive Medicine | 907 E Sunflower Rd, Suite 102, Cleveland, MS 38732-2830 | 2012-03-21 |
| 1891880621 | Ms Wound Care | Preventive Medicine | 1225 N State St, Jackson, MS 39202-2064 | 2006-10-04 |
| 1205873544 | Donn E Bowers Md Apmc | Preventive Medicine | 4500 13th St, Wound Care Dept/memorial Hospital, Gulfport, MS 39501-2515 | 2006-06-02 |
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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.