Individual
DR. LISA CAROLYN MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3540 DULUTH PARK LN STE 290, DULUTH, GA 30096-8511
(706) 489-9623
Mailing address
7635 BLANDFORD PL, ATLANTA, GA 30350-5603
(409) 877-8875
(770) 676-6876
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
A129944
CA
208200000X
Plastic Surgery Physician
P6470
TX
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
79247
GA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
79247
GA
Other
Enumeration date
05/31/2008
Last updated
11/05/2023
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