Doctor Name: | LOLA M POLLARD |
NPI Number: | 1033113519 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 0310 |
Business Practice Address: | 101 Peabody Dr Webster, SD - 572741061 |
Business Phone Number: | 6053454141 |
Business Fax Number: | 6053454135 |
Mailing Address: | Po Box 5074, SIOUX FALLS |
State: | SD |
Postal Code: | 571175074 |
Phone Number: | 6053289556 |
Fax Number: | 6053289501 |
NPI Enumeration Date: | 06/13/2005 |
NPI Last Update Date: | 05/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 0310 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |