Individual
BEN LISCANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
323 SW 10TH ST, MADISON, SD 57042-3200
(605) 256-6551
(605) 256-6469
Mailing address
323 SW 10TH ST, MADISON, SD 57042-3200
(605) 256-6551
(605) 256-6469
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9561
SD
Other
Enumeration date
06/18/2012
Last updated
02/23/2017
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