Lisa Dietz DO PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LISA DIETZ DO PLLC

Practice address

6507 Town Center Dr
Ste a
Clarkston, MI 48346-4826

Phone

(248) 992-9975

Fax

(248) 992-9143

NPI assigned

Sep 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lisa Grace Dietz, DONPI 1629067541

Title

Owner

Phone

(248) 992-9975

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Dietz, DO

  • Family Medicine Physician
  • Clarkston, MI
  • NPI 1629067541

  Internal Medicine

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1447445879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 TOWN CENTER DR",
            "address_2": "STE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464826",
            "telephone_number": "248-992-9975",
            "fax_number": "248-992-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 TOWN CENTER DR",
            "address_2": "STE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464826",
            "telephone_number": "248-992-9975",
            "fax_number": "248-992-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA DIETZ DO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "DIETZ",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-992-9975",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marcia E Lillis, BSN, RN
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• Edward J Lis Jr., D.O.
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• Bryaunte Safiyyah Little
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• Internal Medicine Physician in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.