Organization
LISENBY PODIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT HARRISON LISENBY JR. (PRESIDENT)
(334) 671-1441
Entity
Organization
Contact information
Practice address
1550 E MAIN ST, DOTHAN, AL 36301-3012
(334) 671-1441
(334) 671-1688
Mailing address
1550 E MAIN ST, DOTHAN, AL 36301-3012
(334) 671-1441
(334) 671-1688
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
144
AL
213E00000X
Podiatrist
511
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000074869
—
AL
01
—
74869
BCBS
AL
Enumeration date
11/20/2006
Last updated
05/26/2009
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