LISA DEPTULA, PA, MD
Student in an Organized Health Care Education/Training Program
Active
Individual
NPI: 1184052508
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant | 363A00000X | No | 5601006710 (MI) |
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes | - |
Frequently Asked Questions
NPI 1184052508 is the National Provider Identifier for LISA DEPTULA, PA, MD, a Student in an Organized Health Care Education/Training Program provider located in Southaven, MS. This NPI was enumerated on October 22, 2013.
LISA DEPTULA, PA, MD practices at 7601 SOUTHCREST PKWY, Southaven, MS 38671.
Quick Facts
- NPI
- 1184052508
- Type
- Individual
- Enumerated
- Oct 22, 2013
- Last Updated
- Apr 22, 2025
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