Healthcare Provider Details

I. General information

NPI: 1427046622
Provider Name (Legal Business Name): LISA LAYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA B LAYA MD

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 CENTRAL PIKE STE 105
HERMITAGE TN
37076-2029
US

IV. Provider business mailing address

5653 FRIST BLVD STE 330
HERMITAGE TN
37076-2064
US

V. Phone/Fax

Practice location:
  • Phone: 615-889-7751
  • Fax: 615-885-6527
Mailing address:
  • Phone: 615-889-7751
  • Fax: 615-885-6527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number26917
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: