Provider Demographics
NPI:1992107254
Name:BUTTERFIELD, LISA MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:BUTTERFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2316 WILDWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:AMISSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20106-1884
Mailing Address - Country:US
Mailing Address - Phone:630-715-1421
Mailing Address - Fax:
Practice Address - Street 1:528 WATERLOO RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3011
Practice Address - Country:US
Practice Address - Phone:540-347-0555
Practice Address - Fax:540-347-9198
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009563152W00000X
GAOPT001548152W00000X
VA0618001711152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist