Organization
HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT HOWARD LYSNE MD, MDIV (DIRECTOR)
(910) 399-3927
Entity
Organization
Contact information
Practice address
626 CORDOVA ST STE 102, ANCHORAGE, AK 99501-3783
(910) 399-3927
(855) 774-1303
Mailing address
7212 OYSTER LN, WILMINGTON, NC 28411-7132
(910) 399-3927
(910) 399-3928
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
118712
AK
2084P0802X
Addiction Psychiatry Physician
118712
AK
2084P0804X
Child & Adolescent Psychiatry Physician
118712
AK
Other
Enumeration date
02/25/2017
Last updated
03/14/2017
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