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General NPI Number Information
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NPI Number | 1962662684
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Entity Type | Individual
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Provider Name | LISA K LONGHOFER MD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 6907 JOHN DAVID CIR
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City | AMARILLO
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State | TX
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Zip | 79124-1636
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Country | US
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Telephone | 806-358-0600
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Fax | 806-358-0601
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Provider Business Mailing Address
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Address Line | 6907 JOHN DAVID CIR
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City | AMARILLO
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State | TX
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Zip | 79124-1636
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Country | US
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Telephone | 806-358-0600
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Fax | 806-358-0601
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | P6861
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | P6861
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License Number State | TX
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