Rendon, Lisa R
Rendon, Lisa R is an sole proprietor health care provider with primary practice located at 3381 W Bavaria St , Eagle ID 83616-5341. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hand Surgery, which is considered as her primary health care specialty. Rendon, Lisa R can be contacted via phone (208) 287-1110.Contact Information
Primary practice address
3381 W Bavaria St
Eagle ID 83616-5341
Phone: (208) 287-1110
Fax: (208) 639-4801
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hand Surgery | 207XS0106X | M9105 | Idaho |
Profile Details
| NPI number | 1528049178 |
|---|---|
| LBN Legal business name | Rendon, Lisa R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 10th, 2005 |
| Last updated | May 22nd, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528049178 | NPPES |
| Idaho | MEDICAID | 807057200 |
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