Antonio, Lisa Marie

Antonio, Lisa Marie is an individual health care provider with primary practice located at 222 Tongass Dr , Sitka AK 99835. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Antonio, Lisa Marie can be contacted via phone (907) 966-8318.

Contact Information

Primary practice address
222 Tongass Dr Sitka AK 99835
Phone: (907) 966-8318
Fax: (907) 966-8606
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X MED-RES-LIC 52169 Montana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 134059 Alaska

Profile Details

NPI number 1679951438
LBN Legal business name Antonio, Lisa Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2015
Last updated Oct 8th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679951438 NPPES
Alaska Other 134059 STATE LICENSE

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