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Lisa Wilson
Diagnostic Ultrasound Physician in Lilburn, Georgia
NPI 1043718471

Lisa Wilson is a Diagnostic Ultrasound Physician based in Lilburn, GA and is specialized in Diagnostic Ultrasound. Lisa Wilson practices in Lilburn, GA. The NPI Number for Lisa Wilson is 1043718471 and holds a License No. 58124 (Georgia).

The current practice location address for Lisa Wilson is 950 Indian Trail Lilburn Rd Nw Ste 5D, Lilburn, GA and can be reached out via phone at 470-545-2131.

Location: 950 Indian Trail Lilburn Rd Nw Ste 5D, Lilburn, GA, 30047-6870
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043718471
Provider Name
Lisa Wilson
Credential
Provider Entity Type
Individual
Gender
Female
Address
950 Indian Trail Lilburn Rd Nw Ste 5D, Lilburn, GA, 30047-6870
Phone Number
470-545-2131
Fax Number
Provider Enumeration Date
01/31/2018
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
58124 01 GA REGISTRY
institution
Provider Business Practice Location Address Details
Address
950 Indian Trail Lilburn Rd Nw Ste 5D
City
Lilburn
State
Georgia
Zip
30047-6870
Phone Number
470-545-2131
Fax Number
person
Provider Business Mailing Address Details
Address
950 Indian Trail Lilburn Rd Nw Ste 5D
City
Lilburn
State
Georgia
Zip
30047-6870
Phone Number
470-545-2131
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Ultrasound
Taxonomy
2085U0001X
License No.
58124 (Georgia)
Definition
A Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound.
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