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General NPI Number Information
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NPI Number | 1982068045
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Entity Type | Individual
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Provider Name | COLBY EISENBACH MD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 1050 OLD CAMP RD STE 100
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City | THE VILLAGES
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State | FL
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Zip | 32162-1762
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Country | US
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Telephone | 844-884-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 LAKE SUMTER LNDG
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City | THE VILLAGES
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State | FL
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Zip | 32162-2699
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Country | US
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Telephone | 352-674-8905
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 57.246879
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME163433
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 37206
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License Number State | OK
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