Individual
DR. STAN A EISELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
323 E RIVERSIDE DR STE 224, EAGLE, ID 83616
(208) 302-6000
(208) 302-6055
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642
(208) 302-6000
(208) 302-6055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M8628
ID
Other
Enumeration date
06/07/2006
Last updated
04/11/2019
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