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NPI Code Detail

MEDICARE: DR. LISA M. CASEY DO

MEDICARE: DR. LISA M. CASEY DO
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
1207Q00000XFamily Medicine Physician34.007011OH
2207Q00000XFamily Medicine Physician81494-21WI
3207Q00000XFamily Medicine Physician72480MN
4207Q00000XFamily Medicine PhysicianOS014887PA

General Provider Information

NPI Number : 1215909791
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA M. CASEY DO
Provider Business Mailing Address
First Line : 2400 W VILLARD AVE
Second Line :
City : GLENDALE
State : WI
Zip : 53209-4901
Country : US
Telephone Number : 414-527-8191
Fax Number :
Provider Business Practice Location Address
First Line : 2400 W VILLARD AVE
Second Line :
City : GLENDALE
State : WI
Zip : 53209-4901
Country : US
Telephone Number : 414-527-8191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 05/22/2026

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