Individual
DEBRA B LISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1101 OCILLA RD, DOUGLAS, GA 31533
(912) 384-1900
(912) 389-2105
Mailing address
1101 OCILLA RD, DOUGLAS, GA 31533
(912) 384-1900
(912) 389-2105
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
038849
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00553682C
—
GA
Enumeration date
11/20/2006
Last updated
07/08/2007
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