Healthcare Provider Details

I. General information

NPI: 1386818425
Provider Name (Legal Business Name): LISA G HOLCOMB NEUMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA GAYLE NEUMAN MD

II. Dates (important events)

Enumeration Date: 04/19/2008
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1942 ATKINSON RD STE 100
LAWRENCEVILLE GA
30043-5004
US

IV. Provider business mailing address

1942 ATKINSON RD STE 100
LAWRENCEVILLE GA
30043-5004
US

V. Phone/Fax

Practice location:
  • Phone: 678-775-0600
  • Fax:
Mailing address:
  • Phone: 678-775-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number78369
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: