Provider Demographics
NPI:1437688520
Name:LISA K. LONGHOFER MD PLLC
Entity Type:Organization
Organization Name:LISA K. LONGHOFER MD PLLC
Other - Org Name:PANHANDLE ORTHO AND HAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LONGHOFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-358-0600
Mailing Address - Street 1:6907 JOHN DAVID CIR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-1636
Mailing Address - Country:US
Mailing Address - Phone:806-358-0600
Mailing Address - Fax:806-358-0601
Practice Address - Street 1:6907 JOHN DAVID CIR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-1636
Practice Address - Country:US
Practice Address - Phone:806-358-0600
Practice Address - Fax:806-358-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-12
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6861207X00000X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty