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General NPI Number Information
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NPI Number | 1841507118
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Entity Type | Individual
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Provider Name | LISA MARIE MCAFEE D.O.
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Gender | Female
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 1940 MESQUITE AVE
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-6123
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Country | US
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Telephone | 928-459-3512
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 617
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City | SOMERTON
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State | AZ
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Zip | 85350-0617
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Country | US
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Telephone | 928-315-7910
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 20A11359
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 000
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License Number State | AZ
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