Healthcare Provider Details

I. General information

NPI: 1548221880
Provider Name (Legal Business Name): LISA BREE HUNT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 W THOMAS RD STE 450
PHOENIX AZ
85037-3328
US

IV. Provider business mailing address

9305 W THOMAS RD SUITE 450
PHOENIX AZ
85037-3328
US

V. Phone/Fax

Practice location:
  • Phone: 623-889-6186
  • Fax: 623-889-6188
Mailing address:
  • Phone: 623-889-6186
  • Fax: 623-889-6188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number33628
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: