Provider Demographics
NPI:1750108981
Name:MCGRAW, LILLA S
Entity type:Individual
Prefix:
First Name:LILLA
Middle Name:S
Last Name:MCGRAW
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 COURT ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-3910
Mailing Address - Country:US
Mailing Address - Phone:662-844-6272
Mailing Address - Fax:
Practice Address - Street 1:340 COURT ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-3910
Practice Address - Country:US
Practice Address - Phone:662-844-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant