Provider Demographics
NPI:1225062243
Name:EISENMAN & EISENMAN,M.D.,LLC
Entity Type:Organization
Organization Name:EISENMAN & EISENMAN,M.D.,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:RATHFELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-753-7487
Mailing Address - Street 1:5065 STATE ROAD 7
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33449-4615
Mailing Address - Country:US
Mailing Address - Phone:561-753-7487
Mailing Address - Fax:561-753-8161
Practice Address - Street 1:5065 STATE RD 7
Practice Address - Street 2:SUITE 201
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33449-4615
Practice Address - Country:US
Practice Address - Phone:561-753-7487
Practice Address - Fax:561-753-8161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty