Individual
JAMES EDWARD LISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 E BROAD ST, ELYRIA, OH 44035-6429
(440) 329-5943
(440) 329-5949
Mailing address
125 E BROAD ST, SUITE 114, ELYRIA, OH 44035-6429
(440) 329-5943
(440) 329-5949
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35-06-1768-1
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0757972
—
OH
Enumeration date
10/01/2006
Last updated
09/04/2008
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