person
Mrs. Lisa A. Boget, PA-C
Medical Physician Assistant in Decatur, Illinois
NPI 1619083102

Lisa A. Boget is a Medical Physician Assistant based in Paducah, IL and is specialized in Medical. Lisa A. Boget practices in Decatur, IL and has the professional credentials of PA-C. The NPI Number for Lisa A. Boget is 1619083102 and holds a License No. PA752 (Illinois).

The current practice location address for Lisa A. Boget is 606 W Pershing Rd, Decatur, IL and can be reached out via phone at 217-877-7171 and via fax at 217-877-7481.

Location: 606 W Pershing Rd, Decatur, IL, 42001-9058
person
Provider Profile Details
NPI Number
1619083102
Provider Name
Lisa A. Boget
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
606 W Pershing Rd, Decatur, IL, 42001-9058
Phone Number
217-877-7171
Fax Number
217-877-7481
Provider Enumeration Date
08/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000324636 01 KY ANTHEM
P00080693 01 KY RAILROAD MEDICARE
1619083102 05 IL
institution
Provider Business Practice Location Address Details
Address
606 W Pershing Rd
City
State
Zip
62526-1604
Phone Number
217-877-7171
Fax Number
217-877-7481
person
Provider Business Mailing Address Details
Address
606 W Pershing Rd
City
State
Zip
62526-1604
Phone Number
217-877-7171
Fax Number
217-877-7481
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA752 (Kentucky)
Definition
Definition to come...
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