Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | OS012226 | PA |
NPI | 1538183892 |
---|---|
Provider Name | Lisa S Ayers |
First Address | Lewisburg, PA 17837-9315 |
Second Address | Lewisburg, PA 17837-9313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 04/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OS012226 | PA LICENSE (01) | PA |