MEDICARE: DR. LANCE P EISNER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	0205	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417983859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LANCE P EISNER DPM

Provider Business Mailing Address
First Line	:	10624 S EASTERN AVE
Second Line	:	SUITE A 423
City	:	HENDERSON
State	:	NV
Zip	:	89052-2982
Country	:	US
Telephone Number	:	702-769-2952
Fax Number	:	702-938-0189

Provider Business Practice Location Address
First Line	:	10624 S EASTERN AVE
Second Line	:	SUITE A 423
City	:	HENDERSON
State	:	NV
Zip	:	89052-2982
Country	:	US
Telephone Number	:	702-480-1544
Fax Number	:	702-714-1202

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	05/03/2022

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