Provider Demographics
NPI:1730408360
Name:PAPIC, LISA KAY (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:KAY
Last Name:PAPIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:KAY
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:ATTN: SHMG/HPE
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-416-6933
Mailing Address - Fax:850-416-6934
Practice Address - Street 1:1545 AIRPORT BLVD STE 2000
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8615
Practice Address - Country:US
Practice Address - Phone:850-416-6933
Practice Address - Fax:850-416-6934
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME133483207RH0002X, 207RH0002X
NE28573207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02215800Medicaid