Provider Demographics
NPI:1598742025
Name:MYERS, LISA C (DO)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:C
Last Name:MYERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:C
Other - Last Name:ANTHONY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:850 WALNUT BOTTOM RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-3632
Mailing Address - Country:US
Mailing Address - Phone:717-960-0052
Mailing Address - Fax:717-960-0055
Practice Address - Street 1:850 WALNUT BOTTOM RD
Practice Address - Street 2:SUITE 305
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3632
Practice Address - Country:US
Practice Address - Phone:717-960-0052
Practice Address - Fax:717-960-0055
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009023L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA878849OtherBLUE SHIELD
PA0015855470004Medicaid
50000818OtherCAP BLUE CROSS
G29073Medicare UPIN
PA878849Medicare PIN