Individual
ELIZABETH B EISENBEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8894
(251) 544-2188
Mailing address
PO BOX 2867, MOBILE, AL 36652-2867
(251) 690-8894
(251) 544-2188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 704
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011846
MEDICARE GROUP NUMBER
AL
01
—
1063439065
NPI SITE GROUP PAYEE NUMBER
AL
05
—
630000013
—
AL
Enumeration date
05/21/2010
Last updated
10/18/2011
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