LISA DEPTULA, PA, MD

Student in an Organized Health Care Education/Training Program

Active Individual
NPI: 1184052508

Practice Address

7601 SOUTHCREST PKWY
Southaven, MS 38671

Phone: (662) 772-3607

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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