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Individual

LISA K MCGRAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
209 POINTER TRL W, VAN BUREN, AR 72956-2238
(479) 474-3399
(479) 474-2338
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 925-4562
(615) 628-6877

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E1446
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
132968001
AR
05
200116240A
OK
Enumeration date
05/04/2006
Last updated
08/11/2015
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