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
Phone: (262) 241-1919
Fax: (262) 241-9046
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619354743 | NPPES |
| Wisconsin | MEDICAID | 1619354743 |
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