DR. LISA RENEE CHASTANT (NPI# 1144545195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144545195 |
| Entity Type | Individual |
| Full Name | DR. LISA RENEE CHASTANT |
| Credential | M.D. |
| Practice Address |
81 Mdos/sgomd 301 Fisher St. Keesler Afb MS 39534-2519 |
| Practice Telephone | 2283763501 |
| Practice Fax Number | 2283760060 |
| Mailing Telephone | 2283763501 |
| Mailing Fax Number | 2283760060 |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2019-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 26245 | MS | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
26245 | MS | Allopathic & Osteopathic Physicians |
| N | 2083A0100X |
Preventive Medicine Specialization: Aerospace Medicine |
C1-0009800 | DE | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | C1-0009800 | DE | Allopathic & Osteopathic Physicians |
| Street Address |
81 MDOS/SGOMD 301 FISHER ST. |
| City | KEESLER AFB |
| State | MS |
| Zip Code | 39534-2519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316568918 | Hanna Chang | Student in an Organized Health Care Education/Training Program | 81 Msgs/gme (keesler Afb), 301 Fisher St, Rm 5a127, Biloxi, MS 39534 | 2020-05-05 |
| 1720617079 | Briana Polk | Student in an Organized Health Care Education/Training Program | Keesler Air Force Base, 301 Fisher Street, Biloxi, MS 39534 | 2020-04-07 |
| 1437718756 | Marquise Westbrook | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Rm 1g123, Keesler Afb, MS 39534 | 2019-06-11 |
| 1124682729 | Joseph Paul Cervone | Student in an Organized Health Care Education/Training Program | 81 Mdss/gme 301 Fisher St, Rm 1g123, Keesler Afb, MS 39534 | 2019-04-29 |
| 1083120851 | Kaitlin May Gruenberg | Student in an Organized Health Care Education/Training Program | 81 Msgs/gme, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2017-12-15 |
| 1760912513 | Michael Zipper | Military Health Care Provider | 301 Fisher St, Rm 5a127, 81msgs/sgcq, Keesler Afb, MS 39534 | 2017-06-14 |
| 1184073181 | 81msgs/sgcq | General Acute Care Hospital | 81msgs/sgcq, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-09 |
| 1174972772 | Usaf 81st Medical Group | Military Hospital | 81msgs/sgcq 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-06 |
| 1548644677 | Jim Li | Dentist | 81st Medical Group, Keesler Afb, Apo, AA 39534 | 2015-07-18 |
| 1245610872 | Zachary Austin Masters | Surgery | 301 Fisher Street, Rm 5a127, Keesler Air Force Base, MS 39534 | 2015-06-09 |
| Find all providers in zip 39534 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578583514 | Terry Westmoreland | Dermatology | 2110 5th St N, Columbus, MS 39705-2210 | 2006-07-20 |
| 1497159453 | Pine Belt Dermatology and Skin Cancer Center | Dermatology | 201 S Main St, Petal, MS 39465-2362 | 2014-10-20 |
| 1194124834 | David B Roy Do Pa | Dermatology | 201 S Main St, Petal, MS 39465-2362 | 2014-08-19 |
| 1073828455 | South Central Clinics, Inc | Dermatology | 1410 Jefferson St, Laurel, MS 39440-4243 | 2010-08-10 |
| 1912166703 | William H Black | Dermatology | 2500 N State St, Jackson, MS 39216-4500 | 2008-06-05 |
| City | KEESLER AFB |
| Zip Code | 39534 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.