DR. LISA MARIE WANNAMAKER D.O. NPI 1912069451

NPI Information

  • NPI: 1912069451
  • Provider Name: DR. LISA MARIE WANNAMAKER, D.O.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4720 WASHINGTON RD
    EVANS, GA
    ZIP 30809
  • Phone: (706) 774-7263

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NPI Details

DR. Lisa Marie Wannamaker, D.O. is a family medicine in Evans, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Lisa Marie Wannamaker, D.O. NPI is 1912069451. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4720 WASHINGTON RD
EVANS, GA
ZIP 30809
Phone: (706) 774-7263

The NPI 1912069451 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/14/2006 and was last updated on 6/4/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine55462GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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