MEDICARE: ISADOR H LIEBERMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	35072842L	OH
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	ME100364	FL
3	207XS0117X	Orthopaedic Surgery of the Spine Physician	2292351	NY
4	207XS0117X	Orthopaedic Surgery of the Spine Physician	A85601	CA
5	207XS0117X	Orthopaedic Surgery of the Spine Physician	MD418431	PA
6	207XS0117X	Orthopaedic Surgery of the Spine Physician	036.106531	IL
7	207XS0117X	Orthopaedic Surgery of the Spine Physician	041358	CT
8	207XS0117X	Orthopaedic Surgery of the Spine Physician	4301079354	MI
9	207XS0117X	Orthopaedic Surgery of the Spine Physician	N5808	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033173901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISADOR H LIEBERMAN MD

Provider Business Mailing Address
First Line	:	6020 W PARKER RD
Second Line	:	SUITE 200
City	:	PLANO
State	:	TX
Zip	:	75093-8171
Country	:	US
Telephone Number	:	972-608-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6020 W PARKER RD
Second Line	:	SUITE 200
City	:	PLANO
State	:	TX
Zip	:	75093-8171
Country	:	US
Telephone Number	:	972-608-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	12/10/2014

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Directions to “ ISADOR H LIEBERMAN MD” Practice Location

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