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NPI Code Detail

MEDICARE: DR. LISA LISSETTE BURROUGHS-THUMI MD

MEDICARE: DR. LISA LISSETTE BURROUGHS-THUMI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianMD33241AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
251168235OTHERALBCBS

General Provider Information

NPI Number : 1285631218
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA LISSETTE BURROUGHS-THUMI MD
Provider Business Mailing Address
First Line : 460 AL HIGHWAY 75 N
Second Line :
City : ALBERTVILLE
State : AL
Zip : 35951-3838
Country : US
Telephone Number : 256-891-0300
Fax Number : 256-891-7461
Provider Business Practice Location Address
First Line : 460 AL HIGHWAY 75 N
Second Line :
City : ALBERTVILLE
State : AL
Zip : 35951-3838
Country : US
Telephone Number : 256-891-0300
Fax Number : 256-891-7461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2005
Last Update Date : 12/28/2016

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