Individual
DR. JEFFREY R LISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1041 S MEDICAL DR STE 200, BRIGHAM CITY, UT 84302-3293
(435) 723-5248
(435) 723-5240
Mailing address
1041 S MEDICAL DR STE 200, BRIGHAM CITY, UT 84302-3293
(435) 723-5248
(435) 723-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
178575-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870282100012
—
UT
Enumeration date
07/06/2006
Last updated
04/17/2026
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