Lisa Marie Tolliver, PA-C is a medicare enrolled "Physician Assistant - Medical" in Proctorville, Ohio. Her current practice location is
6276 County Road 107, Proctorville, Ohio. You can reach out to her office (for appointments etc.) via phone at
(888) 221-1826.
Lisa Marie Tolliver is licensed to practice in Kentucky (license number PA1634) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1043598485.
Provider's Profile
Full Name | Lisa Marie Tolliver |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 6276 County Road 107, Proctorville, Ohio |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1043598485
- Provider Enumeration Date: 08/03/2011
- Last Update Date: 11/10/2021
Medicare PECOS Information:
- PECOS PAC ID: 5890965115
- Enrollment ID: I20110824000457
Medical Identifiers
Medical identifiers for Lisa Marie Tolliver such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1043598485 | NPI | - | NPPES |
1043598485 | Medicaid | WV | |
7100179880 | Medicaid | KY | |
P01094323 | Other | KY | RR MEDICARE |
0166746 | Medicaid | OH | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | 2555 (West Virginia) | Secondary |
363AM0700X | Physician Assistant - Medical | 50.003489 (Ohio) | Secondary |
363AM0700X | Physician Assistant - Medical | PA1634 (Kentucky) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Marie Tolliver is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Lisa Marie Tolliver, PA-C Po Box 390, Huntington, WV 25708-0390 Ph: (304) 429-1088 | Lisa Marie Tolliver, PA-C 6276 County Road 107, Proctorville, OH 45669-8867 Ph: (888) 221-1826 |
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