Provider Demographics
NPI:1427008978
Name:BROWN, LISA ANN I (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:BROWN
Suffix:I
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 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:440-285-2960
Mailing Address - Fax:440-285-2959
Practice Address - Street 1:12475 HOSPITAL DR BLDG 2
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9028
Practice Address - Country:US
Practice Address - Phone:440-285-2960
Practice Address - Fax:440-285-2959
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.092418207Q00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2875287Medicaid
OHP00682311OtherRAILROAD MEDICARE
OHP00682311OtherRAILROAD MEDICARE