Provider Demographics
NPI:1306843230
Name:STRNAD, LYSE STUART (MD)
Entity Type:Individual
Prefix:
First Name:LYSE
Middle Name:STUART
Last Name:STRNAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2629 NORTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-9565
Mailing Address - Country:US
Mailing Address - Phone:319-338-3623
Mailing Address - Fax:319-338-7289
Practice Address - Street 1:2629 NORTHGATE DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-9565
Practice Address - Country:US
Practice Address - Phone:319-338-3623
Practice Address - Fax:319-338-7289
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA25445207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA24272OtherBLUE CROSS BLUE SHIELD
IA180022817OtherRAILROAD MEDICARE
IA0242727Medicaid
IA42144513502OtherJOHN DEERE HEALTH
IA0242727Medicaid
IA24272Medicare ID - Type Unspecified