Healthcare Provider Details

I. General information

NPI: 1528060084
Provider Name (Legal Business Name): LISA BROTHERS ARBISSER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 TANGLEFOOT LN
BETTENDORF IA
52722-1650
US

IV. Provider business mailing address

777 TANGLEFOOT LN
BETTENDORF IA
52722-1650
US

V. Phone/Fax

Practice location:
  • Phone: 563-323-2020
  • Fax: 563-328-5694
Mailing address:
  • Phone: 563-323-2020
  • Fax: 563-328-5694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036-076217
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number23550
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: