Mark J. Eisen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25580 Issued in NC

Legal business name

MARK J. EISEN, M.D.

Practice address

900 Martin Luther King Jr Blvd
Sutie a
Chapel Hill, NC 27514-2601

Phone

(919) 967-3452

Fax

(919) 932-5200

NPI assigned

Aug 23, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Marcus W Gillikin, MD, MBA

Title

Consultant

Phone

(252) 353-7162

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255447967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30696",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278330696",
            "telephone_number": "252-353-7162",
            "fax_number": "252-353-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUTIE A",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142601",
            "telephone_number": "919-967-3452",
            "fax_number": "919-932-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK J. EISEN, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GILLIKIN",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "252-353-7162",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD, MBA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "25580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8930263",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David M Margolis, MD
• Lewis Margolis, M.D.
• Shae Margulies, MD
• Caroline Mariano, M.D
• Ashley Mariconti, DNP
• Kelley Rowan Mark
• Serana Spalding Markham, ANP
• Alena Janda Markmann, MD, PHD
• David Morris Marks, MD
• Lawrence B Marks, M.D.

• Family Medicine Physician in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.