| Ms Lisa R Carlson, MD | |
| 1605 Se Delaware Ave, Suite F, Ankeny, IA 50021-4594 | |
| (515) 964-5555 | |
| (515) 964-5505 | 
| Full Name | Ms Lisa R Carlson | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 1605 Se Delaware Ave, Ankeny, Iowa | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1598755522 | NPI | - | NPPES | 
| 1113076 | Medicaid | IA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | IA 30072 (Iowa) | Primary | 
| Entity Name | Iowa Physicians Clinic Medical Foundation | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1366425274 PECOS PAC ID: 8729992318 Enrollment ID: O20031118000363 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ms Lisa R Carlson, MD 1605 Se Delaware Ave, Suite F, Ankeny, IA 50021-4594 Ph: (515) 964-5555 | Ms Lisa R Carlson, MD 1605 Se Delaware Ave, Suite F, Ankeny, IA 50021-4594 Ph: (515) 964-5555 | 
| Dr. Eric A Andersen, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 800 E 1st St Ste 2200, Ankeny, IA 50021 Phone: 515-643-9000 Fax: 515-643-7509 | |
| Stephanie D Wadle-wignall, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 909 Sw Oralabor Rd, Suite 100, Ankeny, IA 50023 Phone: 515-964-4600 Fax: 515-964-9838 | |
| Dr. Melissa Ashbacher Myers, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 120 Nw 36th St, Ankeny, IA 50023 Phone: 515-358-7550 Fax: 515-358-7551 | |
| Daniel L Brink, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 909 Sw Oralabor Rd, Suite 100, Ankeny, IA 50023 Phone: 515-963-4400 Fax: 515-964-9838 | |
| Dr. Katherine Christy Sullivan, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1410 Sw Tradition Dr Ste 200, Ankeny, IA 50023 Phone: 515-875-9420 Fax: 515-875-9741 | |
| Sara L Schutte-schenck, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 800 E 1st St Ste 2200, Ankeny, IA 50021 Phone: 515-643-9000 Fax: 515-643-7509 | |
| Rhonda Lynn Dodge Syata, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 909 Sw Oralabor Rd, Ankeny, IA 50023 Phone: 515-963-4400 Fax: 515-964-9838 |