Individual
DR. JOSEPH P LISANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9347 PENDLETON PIKE, INDIANAPOLIS, IN 46236-2768
(317) 612-3193
(317) 612-3270
Mailing address
9347 PENDLETON PIKE, MONARCH BEVERAGE, INDIANAPOLIS, IN 46236-2768
(317) 612-3193
(317) 612-3270
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003522A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2067918
—
OH
01
—
WA3600441
MEDICARE GROUP
OH
Enumeration date
03/08/2006
Last updated
05/04/2017
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