Individual
LISA COUNSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
707 OLD DALTON ELLIJAY RD, CHATSWORTH, GA 30705-2029
(706) 517-2030
(706) 517-2076
Mailing address
PO BOX 12938, C/O CLINIC MANAGEMENT, CALHOUN, GA 30703-7013
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44314
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007841431
—
GA
Enumeration date
01/24/2007
Last updated
12/14/2018
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