Davidson, Lisa R

Davidson, Lisa R is an individual health care provider with primary practice located at 1230 E Main Street Mankato Clinic At Main Street, Mankato MN 56002-8674. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Davidson, Lisa R can be contacted via phone (507) 625-1811.

Contact Information

Primary practice address
1230 E Main Street Mankato Clinic At Main Street Mankato MN 56002-8674
Phone: (507) 625-1811
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 43496 Minnesota

Profile Details

NPI number 1184603193
LBN Legal business name Davidson, Lisa R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Jul 10th, 2020 - about 4 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 1184603193 NPPES
Minnesota Other 1328361 AMERICAS PPO
Minnesota Other 410849339 56001 C181 AMERICAS PPO
Minnesota Other 0500173 AMERICAS PPO
Minnesota Other 151694 AMERICAS PPO
Minnesota MEDICAID 071645600 AMERICAS PPO
Minnesota Other 0947127 AMERICAS PPO
Minnesota Other 45D61DA AMERICAS PPO
Minnesota Other 130024186 AMERICAS PPO
Minnesota Other HP32997 AMERICAS PPO
Minnesota Other NA2951027572 AMERICAS PPO

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