Provider Demographics
NPI:1831368323
Name:NEWTON, LISANNE P (MD)
Entity type:Individual
Prefix:
First Name:LISANNE
Middle Name:P
Last Name:NEWTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISANNE
Other - Middle Name:PALOMAR
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:505 EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2668
Mailing Address - Country:US
Mailing Address - Phone:912-354-6190
Mailing Address - Fax:912-354-6190
Practice Address - Street 1:2500 STARLING ST STE 101
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520
Practice Address - Country:US
Practice Address - Phone:912-354-6190
Practice Address - Fax:912-354-6172
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA76917207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology