=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275695017
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LISA M COLON M.D. A.P.M.C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2006
-----------------------------------------------------
Last Update Date | 08/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15813 PAUL VEGA MD DR STE 200
-----------------------------------------------------
City | HAMMOND
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70403-1431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-230-7650
-----------------------------------------------------
Fax | 985-230-7655
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 WOMANS WAY
-----------------------------------------------------
City | BATON ROUGE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70817-5100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-924-8550
-----------------------------------------------------
Fax | 225-924-8647
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VG0400X
-----------------------------------------------------
Taxonomy Name | Gynecology Physician
-----------------------------------------------------
License Number | 024722
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 024744
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------