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Individual
DAVID E LIZOTTE
Active
Individual
DAVID E LIZOTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110002429
VA
363A00000X
Physician Assistant
Primary
PA1882
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110002429
PA LICENSE
VA
01
—
1027307
NCCPA CERTIFICATION #
—
05
—
1598826299
—
VA
Enumeration date
12/13/2006
Last updated
11/30/2023
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