Individual
LISA HEATLY MASTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
550 POPE AVE, MUNSON ARMY HEALTH CENTER ATTN:MCXN-COD,MS COTTON, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6562
(913) 684-6208
Mailing address
550 POPE AVE, MUNSON ARMY HEALTH CENTER ATTN:MCXN-COD,MS COTTON, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6562
(913) 684-6208
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-30174
KS
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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