Individual
LISA K BOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1220 JEFFERSON ST, LAUREL, MS 39440-4355
(601) 426-4000
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 649-7075
(228) 497-8869
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
14953
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125418
—
MS
01
—
2288269
AMERICAN ADMIN GROUP
MS
01
—
830008039
RAILROAD MEDICARE
—
Enumeration date
07/28/2006
Last updated
08/09/2024
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