Individual
DR. DANIEL D EISENMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
705 JESSE JEWELL PKWY SE, SUITE 175, GAINESVILLE, GA 30501-3867
(770) 718-9790
(770) 718-5531
Mailing address
705 JESSE JEWELL PKWY SE, SUITE 175, GAINESVILLE, GA 30501-3867
(770) 718-9790
(770) 718-5531
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003084
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP7811
MEDICARE B
GA
Enumeration date
05/10/2007
Last updated
10/30/2008
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