Individual
DR. LISA M AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1260 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4514
(214) 619-1910
(214) 619-1914
Mailing address
1260 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4514
(214) 619-1910
(214) 619-1914
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
053486
GA
2084N0400X
Neurology Physician
ME 94226
FL
2084N0600X
Clinical Neurophysiology Physician
ME 94226
FL
Other
Enumeration date
09/11/2009
Last updated
04/01/2025
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