Lystad, Lisa Douglass

Lystad, Lisa Douglass is an individual health care provider with primary practice located at 23250 Chagrin Blvd Bld 5 Ste 440, Beachwood OH 44122. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Lystad, Lisa Douglass can be contacted via phone (216) 514-1864.

Contact Information

Primary practice address
23250 Chagrin Blvd Bld 5 Ste 440 Beachwood OH 44122
Phone: (216) 514-1864
Fax: (216) 514-1867
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 35061509L Ohio

Profile Details

NPI number 1023089232
LBN Legal business name Lystad, Lisa Douglass
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Jul 8th, 2007 - about 17 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 1023089232 NPPES
Ohio MEDICAID 0884593

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