| Organization Name: | LISA M JUDGE M D P A |
| NPI Number: | 1124220009 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LYNN ROUTHIER (PRACTICE MANAGER) |
| Mailing Address: | 552 Twin Cities Blvd Suite C Niceville |
| State: | FL US |
| Postal Code: | 325781055 |
| Phone Number: | 8507291414 |
| Fax Number: | 8507298700 |
| NPI Enumeration Date: | 06/04/2007 |
| NPI Last Update Date: | 06/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |