Individual
DR. RICHARD N EISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
5555 W THUNDERBIRD RD, GLENDALE, AZ 85306-4622
(602) 685-5211
(602) 685-5325
Mailing address
PO BOX 42210, PHOENIX, AZ 85080-2210
(623) 266-7770
(623) 322-4639
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
50419
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039165
—
AZ
Enumeration date
07/26/2006
Last updated
08/05/2020
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