Individual
DR. LISA MICHELLE HENDRIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
880 W MAIN ST, BOONEVILLE, AR 72927-3443
(479) 675-2800
Mailing address
880 W MAIN ST, BOONEVILLE, AR 72927-3443
(479) 675-2800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E0966
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080128356
RAILROAD MEDICARE
AR
05
—
130231001
—
AR
Enumeration date
11/02/2006
Last updated
08/23/2022
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