Lisle, Benjamin

Lisle, Benjamin is an sole proprietor health care provider with primary practice located at 3801 S National Ave # 900 , Springfield MO 65807-5210. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Lisle, Benjamin can be contacted via phone (417) 875-3000.

Contact Information

Primary practice address
3801 S National Ave # 900 Springfield MO 65807-5210
Phone: (417) 875-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 2020014928 Missouri
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1598143505
LBN Legal business name Lisle, Benjamin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2015
Last updated Jul 29th, 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 1598143505 NPPES
Missouri MEDICAID 200084722

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