Healthcare Provider Details

I. General information

NPI: 1871650242
Provider Name (Legal Business Name): JAMES E. REISSIG II PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 WABASH AVE
AKRON OH
44307-2433
US

IV. Provider business mailing address

542 WINDHAM CT
BROADVIEW HEIGHTS OH
44147-4214
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-1168
  • Fax:
Mailing address:
  • Phone: 440-746-0979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03-2-23068
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: