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LISA B FIRESTONE MD, MPH
>> General Practice >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1134102882
Individual Registrant: LISA B FIRESTONE MD, MPH
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
4175 S ALAMO AVE 355 AMDS DAVIS MONTHAN A F B, AZ 85707-6097 US
Tel: 520-228-2721 Fax: --
Tel: 520-228-2721 Fax: --
Contact information for business:
14336 E MANHEAD LOOKOUT DR VAIL, AZ 85641-2550 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1134102882
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 208D00000X | Allopathic & Osteopathic Physicians General Practice | IN | 01054691A |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
