Individual
JAMES BENEDICT LISOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-3784
Mailing address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-3784
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44849
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44849
LICENSE
WI
Enumeration date
12/06/2005
Last updated
03/12/2014
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