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Contact Information

AUDREY LISTON, DO
787 MARKET ST STE 9
HANCOCK, MI49930
 Phone: 906-482-7762
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for AUDREY LISTON · (Female)

NPI Number 1346354461
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/18/2006
Last updated 01/16/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5101012074
  • MI Medicaid 114387160
  • MI Other AL012074 BLUE CROSS STATE ID
  • MI Other 0829560001 MEDICARE DME
  • MI Other 0C16002 MEDICARE GROUP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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