Provider Demographics
NPI:1619264488
Name:KARRES, LISA MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:KARRES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1930 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-2303
Mailing Address - Country:US
Mailing Address - Phone:740-522-7600
Mailing Address - Fax:740-522-6399
Practice Address - Street 1:1930 TAMARACK RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-2303
Practice Address - Country:US
Practice Address - Phone:740-522-7600
Practice Address - Fax:740-522-6399
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAP2282058A06207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine