Provider Demographics
NPI:1518948736
Name:GIDDAY, LISA K (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:K
Last Name:GIDDAY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1707 COLE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3220
Mailing Address - Country:US
Mailing Address - Phone:303-716-8013
Mailing Address - Fax:303-763-5495
Practice Address - Street 1:8199 SOUTHPARK LN
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5667
Practice Address - Country:US
Practice Address - Phone:303-730-3332
Practice Address - Fax:303-730-7766
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2016-03-02
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Provider Licenses
StateLicense IDTaxonomies
CO30817207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCL5518Medicare PIN
COE82954Medicare UPIN