Provider Demographics
NPI:1508873811
Name:VIOLA, LISA C (DO)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:C
Last Name:VIOLA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S CLIFF AVE
Mailing Address - Street 2:SUITE 506
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1053
Mailing Address - Country:US
Mailing Address - Phone:605-335-0844
Mailing Address - Fax:605-977-1715
Practice Address - Street 1:1301 S CLIFF AVE
Practice Address - Street 2:SUITE 506
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1053
Practice Address - Country:US
Practice Address - Phone:605-335-0844
Practice Address - Fax:605-977-1715
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD50722084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0040469OtherBCBS
SD6100830Medicaid
IA0556001Medicaid
MN724489400Medicaid
MN226T4VIOtherBCBS
H41313Medicare UPIN
IA0556001Medicaid
SD6100830Medicaid