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Individual

DR. LISA JOAN GRAVES-AUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6800 W CENTRAL AVE STE K, TOLEDO, OH 43617-1135
(419) 841-1510
(419) 841-1513
Mailing address
4235 SECOR RD, TOLEDO, OH 43623-4231
(419) 725-6427
(419) 725-6427

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.146256
OH
207R00000X
Internal Medicine Physician
L7399
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
160192401
TX
01
P00061338
MEDICARE RR
Enumeration date
06/02/2006
Last updated
06/06/2024
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