John Mark Lidell, M.M.SC. , PA-C
Physician Assistant · McDonough, GA
Practice location
101 Regency Park Dr Ste 110McDonough, GA 30253-7076
- Phone
- (404) 996-0126
- Fax
- (678) 432-2626
NPI record
- NPI
- 1962487538
- Entity type
- Individual (Type 1)
- Enumeration date
- December 7, 2005
- Last updated
- October 27, 2021
- Certified
- October 27, 2021
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X |
002952 | GA |
Mailing address
3576 Highway 138 SEStockbridge, GA 30281-7909
- Phone
- (770) 474-7448
- Fax
- (770) 474-7194
Other practice locations (2)
- 913 Eagles Landing Pkwy Ste 150, Stockbridge, GA 30281-5011 · (770) 692-5910
- 3576 Highway 138 SE, Stockbridge, GA 30281-7909 · (770) 474-7448
About John Lidell
John Mark Lidell, M.M.SC. , PA-C is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 101 Regency Park Dr Ste 110, McDonough, GA 30253-7076. The NPI number 1962487538 was assigned on December 7, 2005 and the record was last updated on October 27, 2021.
John Lidell lists a license in the registry: #002952 (GA) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of John Mark Lidell, M.M.SC. , PA-C?
The NPI number is 1962487538.
What is the phone number of John Lidell?
The phone number listed for the practice location is (404) 996-0126.
Where is John Lidell located?
101 Regency Park Dr Ste 110, McDonough, GA 30253-7076.
What is the taxonomy code for John Lidell?
The primary taxonomy code is 363A00000X – Physician Assistant.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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