Healthcare Provider Details

I. General information

NPI: 1225477748
Provider Name (Legal Business Name): ERIC ALEXANDER LISS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 HILL TOP LN
LEXINGTON VA
24450-5726
US

IV. Provider business mailing address

17 N MEDICAL PARK DR
FISHERSVILLE VA
22939-2344
US

V. Phone/Fax

Practice location:
  • Phone: 540-463-4140
  • Fax:
Mailing address:
  • Phone: 540-213-7720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101288595
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME132169
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: