Bennett, Lisa

Bennett, Lisa is an individual health care provider with primary practice located at 10320 N Port Washington Rd , Mequon WI 53092-5767. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Bennett, Lisa can be contacted via phone (262) 241-1919.

Contact Information

Primary practice address
10320 N Port Washington Rd Mequon WI 53092-5767
Fax: (262) 241-9046
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 2016014173 Missouri
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 70489 Wisconsin

Profile Details

NPI number 1619354743
LBN Legal business name Bennett, Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2015
Last updated Oct 10th, 2023 - about 3 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 1619354743 NPPES
Wisconsin MEDICAID 1619354743

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