Healthcare Provider Details

I. General information

NPI: 1275695017
Provider Name (Legal Business Name): LISA M COLON M.D. A.P.M.C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15813 PAUL VEGA MD DR STE 200
HAMMOND LA
70403-1431
US

IV. Provider business mailing address

100 WOMANS WAY
BATON ROUGE LA
70817-5100
US

V. Phone/Fax

Practice location:
  • Phone: 985-230-7650
  • Fax: 985-230-7655
Mailing address:
  • Phone: 225-924-8550
  • Fax: 225-924-8647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number024722
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number024744
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: