Eisen, Alexander Mark
Eisen, Alexander Mark is an individual health care provider with primary practice located at 105 E Watts St , Enterprise AL 36330-2511. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Eisen, Alexander Mark can be contacted via phone (334) 393-5437.Contact Information
Primary practice address
105 E Watts St
Enterprise AL 36330-2511
Phone: (334) 393-5437
Fax: (334) 393-4185
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0102201876 | Virginia |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 5800150 | Ohio |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 0102201876 | Virginia |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | DO.1311 | Alabama |
Profile Details
| NPI number | 1366490682 |
|---|---|
| LBN Legal business name | Eisen, Alexander Mark |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 5th, 2006 |
| Last updated | Mar 9th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366490682 | NPPES |
| Virginia | MEDICAID | 0102201876 | |
| Virginia | MEDICAID | 146239 |
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