Provider Demographics
NPI:1659327120
Name:FLEISCHER, LISA A (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:FLEISCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:202 CONWAY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3153
Mailing Address - Country:US
Mailing Address - Phone:406-752-8433
Mailing Address - Fax:406-756-6768
Practice Address - Street 1:202 CONWAY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3153
Practice Address - Country:US
Practice Address - Phone:406-752-8433
Practice Address - Fax:406-756-6768
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MT6351207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1659327120OtherBCBS
MT1659327120Medicaid
MT1659327120Medicaid