Provider Demographics
NPI:1588651269
Name:HARRINGTON, LISA A (DO)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:A
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9249 W LAKE CITY RD
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48629-9602
Mailing Address - Country:US
Mailing Address - Phone:989-422-5122
Mailing Address - Fax:989-422-4378
Practice Address - Street 1:9249 W LAKE CITY RD
Practice Address - Street 2:
Practice Address - City:HOUGHTON LAKE
Practice Address - State:MI
Practice Address - Zip Code:48629-9602
Practice Address - Country:US
Practice Address - Phone:989-422-5122
Practice Address - Fax:989-422-4378
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MILH012131207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3376214Medicaid
MIG27257Medicare UPIN
MI0B04606004Medicare ID - Type Unspecified