NPI age
20 years
Enumerated 2005-12-07
● Active
Type 1 · Individual
PROF. John Mark Lidell, M.M.SC. , PA-C
Lidell is 1 of 18 physician assistant providers in McDonough and 1 of 4616 in Georgia.
Primary specialty
Physician Assistant
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2021-10-27
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 4616 active physician assistant providers in Georgia.
NPI age
20 years
↑ 12 yr above median (8 yr)
State licenses
1 state
9% of peers hold multiple states
Subspecialties
0
24% of peers hold subspecialties
NPI lifetime · 2005 → 2026
2005-12Enumerated in NPPES
2005
2026
Where they practice
Practice location
101 Regency Park Dr Ste 110
McDonough, GA 302537076
Mailing address
3576 Highway 138 Se
Stockbridge, GA 302817909
Additional practice locations
2 secondary locations on file with NPPES.
Location 2
913 Eagles Landing Pkwy Ste 150
Stockbridge, GA 302815011
Location 3
3576 Highway 138 Se
Stockbridge, GA 302817909
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Practice context
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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