MEDICARE: DR. LISA MARIE MCAFEE D.O.

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	207P00000X	Emergency Medicine Physician	20A11359	CA
2	207P00000X	Emergency Medicine Physician	000	AZ

General Provider Information

NPI Number	:	1841507118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA MARIE MCAFEE D.O.

Provider Business Mailing Address
First Line	:	PO BOX 617
Second Line	:
City	:	SOMERTON
State	:	AZ
Zip	:	85350-0617
Country	:	US
Telephone Number	:	928-315-7910
Fax Number	:

Provider Business Practice Location Address
First Line	:	1940 MESQUITE AVE
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-6123
Country	:	US
Telephone Number	:	928-459-3512
Fax Number	:

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

Provider Enumeration Date	:	09/08/2010
Last Update Date	:	01/09/2023

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