Provider Demographics
NPI:1558351809
Name:HILLMAN, LANSING CHARIS (MD)
Entity Type:Individual
Prefix:DR
First Name:LANSING
Middle Name:CHARIS
Last Name:HILLMAN
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 1:307 E 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-3208
Mailing Address - Country:US
Mailing Address - Phone:229-896-8000
Mailing Address - Fax:
Practice Address - Street 1:216 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-3275
Practice Address - Country:US
Practice Address - Phone:229-276-2000
Practice Address - Fax:229-276-3634
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046124207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000899225DMedicaid
GA202I086810Medicare Oscar/Certification
GA000899225DMedicaid