Individual
MR. ERIC ISOM REISINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4140 FERNCREEK DR STE 801, FAYETTEVILLE, NC 28314-2572
(910) 484-2171
(910) 484-4568
Mailing address
4140 FERNCREEK DR STE 801, FAYETTEVILLE, NC 28314-2572
(910) 484-2171
(910) 484-4568
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2016-0097
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154629137
—
VA
01
—
541869550
TRICARE
VA
Enumeration date
03/01/2011
Last updated
08/14/2020
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