Lesley S Dishaw in Green Bay - Physician Assistant
Lesley S Dishaw - NPI 1740262856
Lesley S Dishaw is a Physician Assistant in Green Bay, Wisconsin. Lesley S Dishaw practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Lesley S Dishaw is 1740262856. The last update date is 2020-09-30.
Lesley S Dishaw's current location address is Po Box 22487, Green Bay, Wisconsin. You can contact this provider via phone number 9204457226 and fax number 9204457229. The mailing address for Lesley S Dishaw is Po Box 22487, Green Bay, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lesley S Dishaw |
|---|---|
| Address | Po Box 22487, Green Bay, Wisconsin |
| Phone Number | 9204457226 |
| Fax Number | 9204457229 |
| Sole Proprietor | N |
| Credentials | PAC |
NPI Number Detail
| NPI Number | 1740262856 |
|---|---|
| Provider Enumeration Date | 2005-11-15 |
| Last Updated Date | 2020-09-30 |
Provider Mailing Address Detail
| Address | Po Box 22487 |
|---|---|
| City | Green Bay |
| State | Wisconsin (WI) |
| Post Code | 543052487 |
| Phone Number | 9204457226 |
| Fax Number | 9204457229 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 1236023 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 970028140 | MI | RR MEDICARE | |
| 852210330 | MI | BCBS MI | |
| 41927000 | WI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Lesley S Dishaw by the Centers for Medicare & Medicaid Services?
The Lesley S Dishaw has been assigned the NPI (National Provider Identifier) 1740262856. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Lesley S Dishaw is located?
The Lesley S Dishaw is situated at the following address: Po Box 22487, Green Bay, WI, 543052487.
What is the Lesley S Dishaw's area of specialization and corresponding taxonomy classification?
The Lesley S Dishaw's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1740262856 to Lesley S Dishaw?
The Centers for Medicare & Medicaid Services originally issued the 1740262856 to Lesley S Dishaw on 2005-11-15.
As of what date were the details related to Lesley S Dishaw most recently updated or revised?
The information pertaining to Lesley S Dishaw, including its address, specialty, and other relevant details, was last updated or revised on 2020-09-30.