Provider Demographics
NPI:1265635254
Name:LEHMAN, SALLI CHISM (MD)
Entity Type:Individual
Prefix:
First Name:SALLI
Middle Name:CHISM
Last Name:LEHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2258
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31799-2258
Mailing Address - Country:US
Mailing Address - Phone:229-226-7544
Mailing Address - Fax:229-226-0314
Practice Address - Street 1:509 GORDON AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6645
Practice Address - Country:US
Practice Address - Phone:229-223-7544
Practice Address - Fax:229-226-0314
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64044208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA911549840AMedicaid
GA911549840BMedicaid