Individual
IAN FRANCIS EISENHAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5000
Mailing address
8401 MAYLAND DR STE V, RICHMOND, VA 23294-4648
(570) 367-8625
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207P00000X
Emergency Medicine Physician
Primary
0101283316
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2017
Last updated
01/16/2025
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