Individual
DR. LISA J STATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
975 E 3RD ST, BOX 94, CHATTANOOGA, TN 37403-2103
(423) 778-2998
(423) 778-4452
Mailing address
975 E 3RD ST, BOX 94, CHATTANOOGA, TN 37403-2103
(423) 778-2998
(423) 778-4452
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9700304
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10064539
RAILROAD MEDICARE
NC
01
—
1132K
BCBS NC
NC
05
—
791132K
—
NC
Enumeration date
11/18/2005
Last updated
07/02/2012
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