Individual
DR. LISA ALEXANDRA PANTHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M
Contact information
Practice address
5511 HIGHWAY 280, STE 124, BIRMINGHAM, AL 35242-6585
(205) 623-0169
(205) 623-0167
Mailing address
PO BOX 382257, BIRMINGHAM, AL 35238-2257
(205) 623-0169
(205) 623-0167
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
POD001049
GA
213EP1101X
Primary Podiatric Medicine Podiatrist
POD001049
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001049
GA
213ES0131X
Foot Surgery Podiatrist
POD001049
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
798702845B
—
GA
01
—
P00364374
RAILROAD MEDICARE
GA
Enumeration date
07/18/2006
Last updated
04/09/2014
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