Lister, Douglas S

Lister, Douglas S is an sole proprietor health care provider with primary practice located at 2720 Homestead Road Suite 50, Park City UT 84098-4885. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Lister, Douglas S can be contacted via phone (435) 604-0449.

Contact Information

Primary practice address
2720 Homestead Road Suite 50 Park City UT 84098-4885
Phone: (435) 604-0449
Fax: (435) 649-9202
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X E41920 California

Profile Details

NPI number 1295958312
LBN Legal business name Lister, Douglas S
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 10th, 2007
Last updated Oct 15th, 2012 - about 14 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 1295958312 NPPES
Utah MEDICAID 000065013
Utah Other 6619665-0501

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