Provider Demographics
NPI:1629273115
Name:DOAK, LISA ANNE (DVM)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANNE
Last Name:DOAK
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-2449
Mailing Address - Country:US
Mailing Address - Phone:660-665-1971
Mailing Address - Fax:660-665-1975
Practice Address - Street 1:1220 GREEN ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-2449
Practice Address - Country:US
Practice Address - Phone:660-665-1971
Practice Address - Fax:660-665-1975
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004709174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian