Boget, Lisa A.

Boget, Lisa A. is an individual health care provider with primary practice located at 606 W Pershing Rd , Decatur IL 62526-1604. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Boget, Lisa A. can be contacted via phone (217) 877-7171.

Contact Information

Primary practice address
606 W Pershing Rd Decatur IL 62526-1604
Phone: (217) 877-7171
Fax: (217) 877-7481
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA752 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 085000996 Illinois

Profile Details

NPI number 1619083102
LBN Legal business name Boget, Lisa A.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2006
Last updated Aug 26th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619083102 NPPES
Kentucky Other 000000324636 ANTHEM
Kentucky Other P00080693 ANTHEM
Kentucky MEDICAID 1619083102 ANTHEM

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