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Individual

DR. SCOTT WALKER LISSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-7251
Mailing address
2920 HIGHWOODS BLVD, RALEIGH, NC 27604-0010
(877) 498-4490

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2007-01720
NC
208800000X
Urology Physician
ME81837
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1396726394
RR MEDICARE
NC
01
1396726394
BCBS NC
05
5909256
NC
Enumeration date
11/08/2005
Last updated
03/08/2021
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