Individual
DR. LISA VERNINO MAHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE DIVISION OF RHEUMATOLOGY, JACKSON, MS 39216-4500
(601) 984-5540
(601) 984-5535
Mailing address
2500 NORTH STATE STREET, DIVISION OF RHEUMATOLOGY, JACKSON, MS 39216-4500
(601) 984-6426
(601) 984-5535
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
15213
MS
207RR0500X
Rheumatology Physician
Primary
15213
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08170804
—
MS
Enumeration date
08/03/2006
Last updated
05/12/2015
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