Organization
LISA A. WIRTH, MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA ANN WIRTH MD (DOCTOR/OWNER)
(770) 535-2497
Entity
Organization
Contact information
Practice address
500 SPRING ST SE, SUITE 201, GAINESVILLE, GA 30501-3773
(770) 535-2497
(770) 535-2498
Mailing address
500 SPRING ST SE, SUITE 201, GAINESVILLE, GA 30501-3773
(770) 535-2497
(770) 535-2498
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000677795C
—
GA
Enumeration date
03/04/2009
Last updated
07/13/2016
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