Lisa Deptula, PA, MD

NPI #1184052508 in Southaven, Mississippi

Provider Information

NPI Number: 1184052508
Entity Type: Individual
Name: Lisa Deptula, PA, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Credential: PA, MD
Enumeration Date: Oct 22, 2013
Last Updated: Apr 22, 2025

Practice Location

Address: 7601 SOUTHCREST PKWY
City: Southaven
State: Mississippi
ZIP Code: 38671-4739
Phone: (662) 772-3607

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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