Provider Demographics
NPI:1578609533
Name:KIM, HEAZA LISA (MD)
Entity Type:Individual
Prefix:DR
First Name:HEAZA
Middle Name:LISA
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5908 LYONS VIEW
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919
Mailing Address - Country:US
Mailing Address - Phone:865-583-8768
Mailing Address - Fax:865-450-5203
Practice Address - Street 1:5908 LYONS VIEW
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919
Practice Address - Country:US
Practice Address - Phone:865-583-8768
Practice Address - Fax:865-450-5203
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN407022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry