Individual
DR. ONDREJ JOSEPH LISY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2118
Mailing address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2118
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
44679
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1514490
—
TN
05
—
34471100
—
WI
05
—
ENROLLED
—
IA
01
—
P00036217
RAILROAD MEDICARE
MN
Enumeration date
02/02/2006
Last updated
05/02/2013
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