Provider Demographics
NPI:1639168255
Name:MIHORA, LISA DIANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:DIANNE
Last Name:MIHORA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9151 W THUNDERBIRD RD # G104
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4906
Mailing Address - Country:US
Mailing Address - Phone:623-522-8687
Mailing Address - Fax:623-522-8683
Practice Address - Street 1:9151 W THUNDERBIRD RD # G104
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4906
Practice Address - Country:US
Practice Address - Phone:623-522-8687
Practice Address - Fax:862-522-8683
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2022-08-24
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Provider Licenses
StateLicense IDTaxonomies
AZ44635207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery