Individual
DR. LISA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
977B TAYLOR ST SW, CONYERS, GA 30012-5357
(770) 918-6508
(770) 918-6525
Mailing address
3603 SHEPHERDS LN, LOGANVILLE, GA 30052-3059
(770) 466-7585
(770) 918-6525
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
016466
GA
1835P1300X
Psychiatric Pharmacist
Primary
RPH016466
GA
Other
Enumeration date
08/17/2005
Last updated
01/04/2012
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