James G Liesen

DO | Pediatrics | Male

James G Liesen, DO is a Bolivar, Missouri based Pediatric doctor with medical specialization in General Pediatrics. Current practice location of James G Liesen is 1195 N Oakland Ave, Suite 2, Bolivar, Missouri - 65613-8095. He can be contacted on phone at 417-777-2121 and fax number 417-777-2854. James G Liesen is a sole proprietor of his business.
NPI number (Unique professional ID) for James G Liesen is 1003815291 which was assigned by NPPES on 19 Jul, 2005 and it was last updated on 23 Feb, 2017. James G Liesen license number is 2008032320 for Pediatrics (208000000X) in Missouri.
James G Liesen is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
James G Liesen basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
Specialization :Pediatrics
Provider Name :James G Liesen
Credential :DO
Gender :Male
Business Address:
James G Liesen address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
Primary Address :1195 N Oakland Ave, Suite 2
Bolivar, MO, 65613-8095
United States
Phone Number :417-777-2121
Fax Number :417-777-2854
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
NPI Number : 1003815291
NPI Entity Type : Individual
First Enrolment Date : 19 Jul, 2005
Last Updated On : 23 Feb, 2017
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for James G Liesen are as mentioned. Primary taxonomy code for James G Liesen, DO is 208000000X (Pediatrics).
Taxonomy Code SpecialityPrimaryLicense No.State
208000000XPediatricsNo2101WV
208000000XPediatricsYes2008032320MO
Legacy Identifiers:
Other legacy medical identifiers of James G Liesen such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
IdentifierIdentifier TypeStateIssuer
3810002037MEDICAIDWV
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
Mailing Address :1500 N Oakland Ave
Bolivar, MO, 65613-3011
United States
Phone Number :417-328-6501
Fax Number :417-328-6338
Business Location:
Patients can refer following map for directions to James G Liesen practice address. Don't forget to take prior appointment before visiting.

** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.