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:
Health care specialties
| Specialty | Code | License # | 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 19 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 | 1023089232 | NPPES |
| Ohio | MEDICAID | 0884593 |
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