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NPI Code Detail

MEDICARE: MRS. LISA MCGRAW M.S., FAAA

MEDICARE: MRS. LISA MCGRAW M.S., FAAA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237600000XAudiologist-Hearing Aid Fitter205OK

General Provider Information

NPI Number : 1386056182
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA MCGRAW M.S., FAAA
Provider Business Mailing Address
First Line : 1900 W MEMORIAL RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73134-6504
Country : US
Telephone Number : 405-936-9033
Fax Number :
Provider Business Practice Location Address
First Line : 1900 W MEMORIAL RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73134-6504
Country : US
Telephone Number : 405-936-9033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2014
Last Update Date : 05/28/2014

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