Provider Demographics
NPI:1497982003
Name:JAMBUSARIA, LISA HARESH (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:HARESH
Last Name:JAMBUSARIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-284-4086
Mailing Address - Fax:615-284-7501
Practice Address - Street 1:2011 MURPHY AVE STE 601
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2220
Practice Address - Country:US
Practice Address - Phone:615-284-2988
Practice Address - Fax:615-284-2995
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000049585207VF0040X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery