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General NPI Number Information
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NPI Number | 1023224797
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Entity Type | Organization
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Legal Business Name | LISA L GUYOT MD PHD PC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 03/24/2010
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Provider Practice Location Address
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Address Line | 3642 GENESYS PKWY
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City | GRAND BLANC
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State | MI
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Zip | 48439-8070
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Country | US
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Telephone | 810-606-7340
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Fax | 810-606-7770
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Provider Business Mailing Address
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Address Line | 841 HEALTH PARK BOULEVARD
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City | GRAND BLANC
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State | MI
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Zip | 48439-8070
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Country | US
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Telephone | 810-606-7340
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Fax | 810-606-7770
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Authorized Official
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Title or Position | NEUROSURGEON
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Name | DR. LISA LEE GUYOT
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Credential | MD PHD
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Telephone | 810-606-7340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | LG063620
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License Number State | MI
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