Individual
LARRY L LISMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7430 N SHADELAND AVE, SUITE 100, INDIANAPOLIS, IN 46250-2070
(317) 596-9804
Mailing address
2901 OHIO BLVD, SUITE 127, TERRE HAUTE, IN 47803-2239
(812) 234-8261
(812) 234-8262
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01030377
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100251430
—
IN
Enumeration date
08/29/2005
Last updated
05/10/2010
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