Individual
DR. GREGORY IAN LISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4315 DIPLOMACY DR, ANCHORAGE, AK 99508-5926
(907) 563-2662
Mailing address
4315 DIPLOMACY DR, ANCHORAGE, AK 99508-5926
(907) 563-2662
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
147767
AK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2013
Last updated
09/11/2019
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