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Dr. Benjamin Lisle, MD
Student in an Organized Health Care Education/Training Program in Springfield, Missouri
NPI 1598143505

Benjamin Lisle is a Student in an Organized Health Care Education/Training Program based in Springfield, MO. Benjamin Lisle practices in Springfield, MO and has the professional credentials of MD. The NPI Number for Benjamin Lisle is 1598143505 and holds a License No. 2020014928 (Missouri).

The current practice location address for Benjamin Lisle is 3801 S National Ave # 900, Springfield, MO and can be reached out via phone at 417-875-3000.

Location: 3801 S National Ave # 900, Springfield, MO, 65808-9007
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1598143505
Provider Name
Benjamin Lisle
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
3801 S National Ave # 900, Springfield, MO, 65808-9007
Phone Number
417-875-3000
Fax Number
Provider Enumeration Date
05/11/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200084722 05 MO
institution
Provider Business Practice Location Address Details
Address
3801 S National Ave # 900
City
Springfield
State
Missouri
Zip
65807-5210
Phone Number
417-875-3000
Fax Number
person
Provider Business Mailing Address Details
Address
3801 S National Ave # 900
City
Springfield
State
Missouri
Zip
65807-5210
Phone Number
417-875-3000
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neurology
Taxonomy
2084N0400X
License No.
()
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
2020014928 (Missouri)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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