James G Liesen
Pediatrician
1195 N Oakland Ave Suite 2
Bolivar
, Missouri 65613-8095
James G Liesen
Pediatrician
1195 N Oakland Ave Suite 2
Bolivar
, Missouri 65613-8095
(417) 328-6338
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About
Features
Specialties
- Pediatrician
Languages spoken
- English
Location
First Address
- James G Liesen
- 1500 N Oakland Ave
- Bolivar, MO
- Zip : 65613-3011
- Fax : (417) 328-6338
- Phone : (417) 328-6501
Second Address
- James G Liesen
- 1195 N Oakland Ave Suite 2
- Bolivar, MO
- Zip : 65613-8095
- Fax : (417) 777-2854
- Phone : (417) 777-2121
Reviews
FAQs
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Is James G Liesen a sole practitioner?
Is James G Liesen accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | 2008032320 | MO |
| N | 208000000X | Pediatrician | 2101 | WV |
National Provider Identifier
| NPI | 1003815291 |
|---|---|
| Provider Name | James G Liesen |
| First Address | Bolivar, MO 65613-3011 |
| Second Address | Bolivar, MO 65613-8095 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/07/2005 |
| Last Update Date | 23/02/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3810002037 | (05) | WV |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.