Active NPI
David Samuel Eisner, M. D.
- Anesthesiology Physician
- Dacula, GA
National Provider Identifier
1497191779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 21972
- Practice address
- 2936 Old Peachtree Rd
Dacula, GA 30019-2047 - Phone
- (770) 513-3093
- NPI assigned
- May 14, 2013
- Last updated
- May 14, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 21972 | GA | Primary |
Addresses
Primary practice location
2936 Old Peachtree Rd
Dacula, GA 30019-2047
Mailing address
2936 Old Peachtree Rd
Dacula, GA 30019-2047
Phone (770) 513-3093
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21972 | GA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368489600000",
"number": "1497191779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2936 OLD PEACHTREE RD",
"city": "DACULA",
"state": "GA",
"postal_code": "300192047",
"telephone_number": "770-513-3093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2936 OLD PEACHTREE RD",
"city": "DACULA",
"state": "GA",
"postal_code": "300192047",
"telephone_number": "770-513-3093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISNER",
"first_name": "DAVID",
"middle_name": "SAMUEL",
"credential": "M. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-14",
"last_updated": "2013-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "GA",
"license": "21972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dacula, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.