National Provider Identifier Database

LISA C MOODY, MD – NPI #1598923021
Plastic and Reconstructive Surgery


Contact Information

LISA C MOODY, MD
3540 DULUTH PARK LN STE 290
DULUTH, GA30096-8511
Phone: 706-489-9623
Fax:
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X
Plastic Surgery 208200000X
Surgery of the Hand 2082S0105X

* Indicates primary specialty

NPI Profile & details for LISA C MOODY

NPI Number 1598923021
Credentials MD
Entity Individual
Enumeration date 05/31/2008
Last updated 11/05/2023 - About 3 years ago
Sole proprietor1 No
Identifiers
  • CA License #: A129944
  • GA License #: 79247
  • TX License #: P6470
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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