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General NPI Number Information
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NPI Number | 1346277191
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Entity Type | Individual
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Provider Name | THOMAS L. LISSMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 1610 8TH AVE E
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City | ALEXANDRIA
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State | MN
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Zip | 56308-2472
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Country | US
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Telephone | 320-335-6213
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Fax | 320-759-1002
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Provider Business Mailing Address
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Address Line | 1610 8TH AVE E
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City | ALEXANDRIA
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State | MN
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Zip | 56308-2472
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Country | US
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Telephone | 320-335-6201
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Fax | 541-768-5201
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 74274
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD22054
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License Number State | OR
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