Provider Demographics
NPI:1255598959
Name:EISNER, RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:EISNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PLANTATION CENTRE DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-2079
Mailing Address - Country:US
Mailing Address - Phone:478-405-2020
Mailing Address - Fax:
Practice Address - Street 1:125 PLANTATION CENTRE DR
Practice Address - Street 2:SUITE 250
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2079
Practice Address - Country:US
Practice Address - Phone:478-405-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA42238207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology