Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisa Deptula, PA, MD

Individual provider Physician Assistant · NPI 1184052508

Lisa Deptula, PA, MD is a Physician Assistant in Southaven, Mississippi. Works from 3 locations. Licensed in California and Michigan.

Licensed in
CA, MI
In the registry since
2013
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone: (662) 772-3607
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2144 4th St Ste A, San Rafael, CA 94901 — (415) 390-2060
  • 203 Winston Dr, Marshall, MI 49068-8526 — (269) 789-1670

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Physician Assistant Taxonomy 363A00000X · Licence PA54017 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 5601006710 (MI)

Record details

NPI number1184052508
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA , MD
Sole proprietorNo
NPI enumeratedOctober 22, 2013
Last updated in NPPESApril 22, 2025
Certification dateApril 22, 2025

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