Johnson, Lisa R

Johnson, Lisa R is an individual health care provider with primary practice located at 420 Community Dr Ste 1 , North Liberty IA 52317-6706. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Johnson, Lisa R can be contacted via phone (319) 626-6006.

Contact Information

Primary practice address
420 Community Dr Ste 1 North Liberty IA 52317-6706
Phone: (319) 626-6006
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34720 Iowa

Profile Details

NPI number 1265584312
LBN Legal business name Johnson, Lisa R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2007
Last updated Jun 27th, 2016 - about 9 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 1265584312 NPPES
Iowa Other 37090 WELLMARK
Iowa MEDICAID 1242636 WELLMARK

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