Provider Demographics
NPI:1053303545
Name:GIRARD, GIGI LISA (MD)
Entity type:Individual
Prefix:DR
First Name:GIGI
Middle Name:LISA
Last Name:GIRARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:4123 DUTCHMANS LN STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4721
Practice Address - Country:US
Practice Address - Phone:502-899-6700
Practice Address - Fax:502-899-6740
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38468207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64099039Medicaid
KYK024750OtherMEDICARE PTAN- WOMEN'S SPECIALISTS
KY0386315Medicare PIN
KYK024750OtherMEDICARE PTAN- WOMEN'S SPECIALISTS
I02917Medicare UPIN